Organization
STEPHENVILLE 2108 ER PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAXTON NEIMAN (GENERAL COUNSEL)
(817) 421-0034
Entity
Organization
Contact information
Practice address
2108 W WASHINGTON ST, STEPHENVILLE, TX 76401-3928
(817) 421-0012
(817) 421-0036
Mailing address
PO BOX 93741, SOUTHLAKE, TX 76092-0117
(817) 421-0012
(817) 421-0036
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
10/31/2017
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