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Organization
STEPHEN F. AUSTIN STATE UNIVERSITY
Active
Organization
STEPHEN F. AUSTIN STATE UNIVERSITY
Active
Other names
Stephen F. Austin State University Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAKER PATILLO PHD (PRESIDENT)
(936) 468-2201
Entity
Organization
Contact information
Practice address
712 HAYTER, 13010 SFA STATION, NACOGDOCHES, TX 75962-3940
(936) 468-3506
(936) 468-4580
Mailing address
712 HAYTER, PO BOX 13010 SFA STATION, NACOGDOCHES, TX 75962-3940
(936) 468-3506
(936) 468-4580
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/02/2012
Last updated
02/27/2014
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