Organization
WEST STATE MHT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN SMITH (MANAGER OF REGULATORY COMPLIANCE)
(855) 860-2109
Entity
Organization
Contact information
Practice address
379 PEAVY RD, LEESVILLE, LA 71446-9514
(855) 860-2109
Mailing address
1515 HERITAGE DR, SUITE 110, MCKINNEY, TX 75069-3379
(855) 860-2109
(855) 814-8428
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11865R
LA
Other
Enumeration date
01/10/2014
Last updated
01/22/2014
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