Organization Name: | IN & OUT CLINIC PA |
NPI Number: | 1023430873 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT DAVID KISTLER (OWNER) |
Mailing Address: | 3802 S Medford Dr Lufkin |
State: | TX US |
Postal Code: | 759015780 |
Phone Number: | 9366342231 |
Fax Number: | 9366348012 |
NPI Enumeration Date: | 01/14/2014 |
NPI Last Update Date: | 02/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |