Organization
GULF BEND MH-MR CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD L. POLZIN (EXECUTIVE DIRECTOR)
(361) 582-2314
Entity
Organization
Contact information
Practice address
6502 NURSERY DRIVE, SUITE 100, VICTORIA, TX 77904-1178
(361) 575-0611
(361) 578-5500
Mailing address
6502 NURSERY DRIVE, SUITE 100, VICTORIA, TX 77904-1178
(361) 575-0611
(361) 578-5500
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
13921
TX
Other
Enumeration date
08/07/2007
Last updated
11/21/2008
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