| Organization Name: | PACKARD MEDICAL GROUP, P.A. |
| NPI Number: | 1821145483 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STANTON C. PACKARD (OWNER) |
| Mailing Address: | 2421 Worth St Hemphill |
| State: | TX US |
| Postal Code: | 759481948 |
| Phone Number: | 4097873772 |
| Fax Number: | 4097874506 |
| NPI Enumeration Date: | 01/05/2007 |
| NPI Last Update Date: | 02/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | J6641 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |