Organization
BIG COUNTRY VEIN RELIEF LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARLENE N GAULDEN (BOM)
(325) 647-4397
Entity
Organization
Contact information
Practice address
109 S PARK DR, BROWNWOOD, TX 76801-5917
(325) 643-3300
(325) 641-8714
Mailing address
4716 S 14TH ST, ABILENE, TX 79605-4733
(325) 795-1200
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0084NJ
BCBS
TX
Enumeration date
02/02/2008
Last updated
02/02/2008
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