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Organization
STEPHEN F. AUSTIN STATE UNIVERSITY
Active
Organization
STEPHEN F. AUSTIN STATE UNIVERSITY
Active
Other names
SFASU Student Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAKER PATILLO PHD (PRESIDENT)
(936) 468-4580
Entity
Organization
Contact information
Practice address
2106 RAQUET ST, NACOGDOCHES, TX 75962-0001
(936) 468-4006
Mailing address
2106 RAQUET ST, PO BOX 13058 SFA STATION, NACOGDOCHES, TX 75962-0001
(936) 468-4006
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
04/19/2013
Last updated
04/19/2013
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