Organization
KEVIN R WADDELL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN R. WADDELL M.D. (PROVIDER)
(409) 212-1000
Entity
Organization
Contact information
Practice address
740 HOSPITAL DR, SUITE 250, BEAUMONT, TX 77701-4664
(409) 212-1000
(409) 212-1003
Mailing address
740 HOSPITAL DR, SUITE 250, BEAUMONT, TX 77701-4664
(409) 212-1000
(409) 212-1003
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M4976
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184820201
—
TX
05
—
184820202
—
TX
Enumeration date
10/19/2006
Last updated
09/26/2014
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