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Organization
GIDMEC, LP
Active
Organization
GIDMEC, LP
Active
Other names
Giddings MEC, LP
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WALKER (CLINIC ADMINISTRATOR)
(325) 695-5440
Entity
Organization
Contact information
Practice address
721 E AUSTIN ST, GIDDINGS, TX 78942-3403
(979) 542-9519
(979) 542-9428
Mailing address
PO BOX 270, GIDDINGS, TX 78942-0270
(979) 542-9519
(979) 542-9428
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K6878
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0037RQ
BCBS GROUP NUMBER
TX
01
—
45D0968578
CLIA NUMBER
TX
Enumeration date
11/21/2006
Last updated
05/01/2009
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