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Organization
SOS HEALTHCARE CENTER, INC.
Active
Organization
SOS HEALTHCARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES C STIDHAM JR. (CEO)
(817) 477-9494
Entity
Organization
Contact information
Practice address
980 N WALNUT CREEK DR, SUITE 100, MANSFIELD, TX 76063-8019
(817) 477-5700
(817) 477-9122
Mailing address
304 E BROAD ST, MANSFIELD, TX 76063-1706
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/01/2009
Last updated
07/01/2009
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