Nacogdoches Internal Medicine Pllc
LBN: Nacogdoches Internal Medicine Pllc
Nacogdoches Internal Medicine Pllc is an health care organization with primary practice located at 412 North St Ste E , Nacogdoches TX 75961. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty.
Nacogdoches Internal Medicine Pllc can be contacted via phone (936) 560-1812, or through Wilson, Walter Brad via phone (936) 560-1812.
Contact Information
Primary practice address
412 North St Ste E
Nacogdoches TX 75961
Phone: (936) 560-1812
Fax: (936) 560-3070
Website:
Authorized official contact:
Name: Wilson, Walter Brad Doctor of Medicine (MD)
Phone: (936) 560-1812
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | H3293 | Texas |
Profile Details
| NPI number | 1609319458 |
|---|---|
| LBN Legal business name | Nacogdoches Internal Medicine Pllc |
| DBA Doing business as | |
| Authorized official | Wilson, Walter Brad Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 28th, 2016 |
| Last updated | May 21st, 2018 - about 8 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609319458 | NPPES |
| Texas | MEDICAID | 377530601 | |
| Texas | MEDICAID | 113906502 |
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