Organization
WACO PM&R GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD E SCOTT JR. D.O. (PRESIDENT)
(254) 753-7200
Entity
Organization
Contact information
Practice address
50 HILLCREST MEDICAL BLVD., SUITE 104, WACO, TX 76712
(254) 753-7200
(254) 753-0388
Mailing address
PO BOX 22052, WACO, TX 76702-2052
(254) 753-7200
(254) 753-0388
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J8763
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1136053-04
—
TX
01
—
250011083
MEDICARE RAILROAD
TX
Enumeration date
11/18/2005
Last updated
01/27/2010
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