Organization
BRAZOS WOUND ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUGH M TADLOCK MD (OWNER)
(512) 508-1809
Entity
Organization
Contact information
Practice address
1605 ROCK PRAIRIE RD, SUITE 102, COLLEGE STATION, TX 77845-8358
(979) 764-4325
(979) 764-4345
Mailing address
PO BOX 4063, BRYAN, TX 77805-4063
(979) 764-4325
(979) 764-4345
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
L0167
TX
Other
Enumeration date
04/16/2007
Last updated
04/30/2015
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