Organization
MID-CITIES MEDICAL INSTITUTE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES E WILLIS II M.D. (PRESIDENT)
(817) 498-7400
Entity
Organization
Contact information
Practice address
8208 BEDFORD EULESS RD, NORTH RICHLAND HILLS, TX 76180-7214
(817) 498-7400
(817) 503-9967
Mailing address
PO BOX 1583, COLLEYVILLE, TX 76034-1583
(817) 498-7400
(817) 503-9967
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
DC6911
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
J0365
TX
208D00000X
General Practice Physician
Primary
MCH-7354
TX
Other
Enumeration date
01/22/2009
Last updated
07/27/2009
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