Organization Name: | REGIONAL HEALTH CLINIC AT TERRELL PLLC |
NPI Number: | 1306119490 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LARRY W HAMBERLIN (OWNER/PROVIDER) |
Mailing Address: | 1553 State Highway 34 S Ste 100 Terrell |
State: | TX US |
Postal Code: | 751604833 |
Phone Number: | 9725631475 |
Fax Number: | 9725245132 |
NPI Enumeration Date: | 02/20/2012 |
NPI Last Update Date: | 12/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 774755 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |