Organization
TLC CEC PARKDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BRAXTON NEIMAN ESQ. (GENERAL COUNSEL)
(817) 421-0034
Entity
Organization
Contact information
Practice address
4117 S STAPLES ST, 140, CORPUS CHRISTI, TX 78411-5505
(817) 421-0034
(817) 421-0036
Mailing address
PO BOX 93027, SOUTHLAKE, TX 76092-1027
(817) 421-0034
(817) 421-0036
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/12/2016
Last updated
01/13/2016
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