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Organization
RAYMOND WESTBROOK DO PA
Active
Organization
RAYMOND WESTBROOK DO PA
Active
Parent organization
RAYMOND WESTBROOK DO PA
Other names
Genesis Integrated Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
RAYMOND WESTBROOK DO PA
Authorized official
STACY LYLES HAWKINS (CREDENTIALING)
(361) 356-3110
Entity
Organization
Contact information
Practice address
520 E NORTHWEST HWY STE 102, GRAPEVINE, TX 76051
(817) 328-1922
(817) 328-1933
Mailing address
2701 MATLOCK RD STE 105, ARLINGTON, TX 76015-2529
(817) 786-3040
(817) 786-3041
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045797003
—
TX
05
—
045797004
—
TX
05
—
045797005
—
TX
Enumeration date
07/19/2018
Last updated
07/30/2018
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