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Individual

HUGH M TADLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1605 ROCK PRAIRIE RD, SUITE 102, COLLEGE STATION, TX 77845-8358
(512) 508-1809
Mailing address
PO BOX 4063, BRYAN, TX 77805-4063
(512) 508-1809

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G3835
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
742587049
TAX ID
TX
Enumeration date
04/11/2006
Last updated
04/22/2015
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