Organization Name: | TOWER MEDICAL CENTER OF NEDERLAND PA |
NPI Number: | 1033294004 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LANCE CRAIG (OWNER PHYSICIAN) |
Mailing Address: | 2100 Hwy 365 Nederland |
State: | TX US |
Postal Code: | 77627 |
Phone Number: | 4097242321 |
Fax Number: | 4097297237 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | E2524 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |