Organization
DIAGNOSTIC SWALLOWING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A WOLFE (MANAGING MEMBER)
(903) 439-6419
Entity
Organization
Contact information
Practice address
34 COUNTY ROAD 1102, SULPHUR SPRINGS, TX 75482-6620
(903) 439-6419
Mailing address
34 COUNTY ROAD 1102, SULPHUR SPRINGS, TX 75482-6620
(903) 439-6419
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00117DC
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
02/27/2006
Last updated
08/22/2020
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