Organization
C. H. WILKINSON PHYSICIAN NETWORK
Active
Other names
The Clinic at Walmart, Store #75
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA J MIKULECKY (CEO PRESIDENT)
(713) 277-2202
Entity
Organization
Contact information
Practice address
3636 MONROE HWY, PINEVILLE, LA 71360-4127
(318) 641-3137
Mailing address
1700 WEST LOOP S, SUITE 400B, HOUSTON, TX 77027-3005
(713) 227-2222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445266
—
LA
Enumeration date
04/23/2010
Last updated
04/23/2010
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