Individual
PETER G. FADOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4730 COLLEGE DR, 6515 KEMP BLVD, WICHITA FALLS, TX 76308, VERNON, TX 76384-4009
(940) 552-9901
Mailing address
4730 COLLEGE DR, 6515 KEMP BLVD, WICHITA FALLS, TX 76308, VERNON, TX 76384-4009
(940) 552-9901
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
J7951
TX
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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