Organization
JACK R. TOMLINSON
Active
Organization
JACK R. TOMLINSON
Active
Other names
Wichita Falls Neuropsychiatric Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY L YOUNG (OFFICE ADMINISTRATOR)
(940) 723-0012
Entity
Organization
Contact information
Practice address
2410 9TH ST, WICHITA FALLS, TX 76301-4033
(940) 723-0012
(940) 723-2058
Mailing address
2410 9TH ST, WICHITA FALLS, TX 76301-4033
(940) 723-0012
(940) 723-2058
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
740
OK
103TC0700X
Clinical Psychologist
Primary
898
TX
2084P0800X
Psychiatry Physician
C6537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033342901
—
TX
05
—
097024601
—
TX
05
—
100151170A
—
OK
05
—
100841430A
—
OK
01
—
8F9754
MEDICARE ID-TYPE UNSPECIFIED
TX
01
—
8F9755
MEDICARE ID-TYPE UNSPECIFIED
TX
01
—
OA0231
MEDICARE ID-TYPE UNSPECIFIED
TX
Enumeration date
03/23/2007
Last updated
01/15/2009
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