Organization
MCKENNA ORTHOPAEDIC AND SPORTS MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL WADE MCKENNA D.O. (OWNER)
(940) 393-6484
Entity
Organization
Contact information
Practice address
1713 S FM 51, #103, DECATUR, TX 76234-3642
(940) 627-6976
(940) 687-9035
Mailing address
1713 S FM 51, #103, DECATUR, TX 76234-3642
(940) 627-6976
(940) 687-9035
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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