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Organization

SPECTRA MEDICAL HOME MHT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELMER GARI OWENS (OWNER)
(855) 860-2109
Entity
Organization

Contact information

Practice address
12500 NE 36TH ST, CHOCTAW, OK 73020-9111
(855) 860-2109
Mailing address
1515 HERITAGE DRIVE, SUITE 110, MCKINNEY, TX 75069-3379
(972) 616-4702

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA619
OK

Other

Enumeration date
03/04/2014
Last updated
03/04/2014
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