Organization Name: | ORTHOPEDIC SPECIALISTS OF TEXARKANA PLLC |
NPI Number: | 1629034863 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFREY THOMAS DEHAAN (CEO) |
Mailing Address: | 1002 Texas Blvd. Suite 501 Texarkana |
State: | TEXAS UM |
Postal Code: | 75501 |
Phone Number: | 9037925005 |
Fax Number: | 9037911569 |
NPI Enumeration Date: | 04/25/2006 |
NPI Last Update Date: | 06/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G2594 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |