Organization
CLINICA DE LA FAMILIA HISPANA EBENEZER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADDEL CASTELLANOS MATOS (OWNER)
(682) 738-3358
Entity
Organization
Contact information
Practice address
522 BEDFORD RD, BEDFORD, TX 76022-6505
(682) 738-3358
(682) 738-3117
Mailing address
522 BEDFORD RD, BEDFORD, TX 76022-6505
(682) 738-3358
(682) 738-3117
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/16/2024
Last updated
09/16/2024
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