Organization
STEPHEN F. AUSTIN STATE UNIVERSITY
Active
Other names
SFASU Student Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAKER PATILLO PHD (PRESIDENT)
(936) 468-4580
Entity
Organization
Contact information
Practice address
2106 RAQUET ST, NACOGDOCHES, TX 75962-0001
(936) 468-4006
Mailing address
2106 RAQUET ST, PO BOX 13058 SFA STATION, NACOGDOCHES, TX 75962-0001
(936) 468-4006
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/19/2013
Last updated
04/19/2013
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