Individual
MR. HECTOR MEDELLIN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
6014 COUNTY ROAD 4068, KEMP, TX 75143-2600
(903) 603-4322
Mailing address
6014 COUNTY ROAD 4068, KEMP, TX 75143-2600
(903) 603-4322
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1015900
TX
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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