Organization
JOHN L SAWTELLE DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN HARRISON CPC CMC (PROVIDER ENROLLMENT COORDINATOR)
(903) 510-1113
Entity
Organization
Contact information
Practice address
218 PARK ST, TRINIDAD, TX 75163-6060
(903) 778-2942
(903) 778-2537
Mailing address
218 PARK ST, TRINIDAD, TX 75163-6060
(903) 778-2942
(903) 778-2537
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
G0063
TX
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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