Organization
ATHENS INTEGRATIVE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ROY CARTER NP-C (OWNER)
(903) 675-8889
Entity
Organization
Contact information
Practice address
714 S PALESTINE ST, ATHENS, TX 75751-3325
(903) 675-8889
Mailing address
714 S PALESTINE ST, ATHENS, TX 75751-3325
(903) 675-8889
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F0613561
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00037N
MEDICARE ID-TYPE UNSPECIFIED
TX
Enumeration date
08/15/2013
Last updated
08/15/2013
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