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Organization
SANGER AVENUE MEDICAL
Active
Organization
SANGER AVENUE MEDICAL
Active
Other names
Patricia A Wilcox M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS L HORNER PH.D. (CLINIC ADMINISTRATOR)
(254) 752-2300
Entity
Organization
Contact information
Practice address
6614 SANGER AVE, WACO, TX 76710-4253
(254) 752-2300
(254) 752-9436
Mailing address
6614 SANGER AVE, WACO, TX 76710-4253
(254) 752-2300
(254) 752-9436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J8840
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121360505
—
TX
Enumeration date
11/07/2005
Last updated
06/10/2008
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