is a Internal Medicine in Mineral Wells, Texas. practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for is 1871643007. The last update date is .
's current location address is 220a Sw 26th Ave, Mineral Wells, Texas. You can contact this provider via phone number 9403251543 and fax number 9403252679. The mailing address for is 220a Sw 26th Ave, Mineral Wells, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 220a Sw 26th Ave, Mineral Wells, Texas |
| Phone Number | 9403251543 |
| Fax Number | 9403252679 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1871643007 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 220a Sw 26th Ave |
|---|---|
| City | Mineral Wells |
| State | Texas (TX) |
| Post Code | 76067 |
| Phone Number | 9403251543 |
| Fax Number | 9403252679 |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | J4552 |
|
Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 80780Y | BCBS | ||
| 135150408 | TX | -- | |
| 135150406 | TX | -- | |
| TXB158020 | TX | PTAN |
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