Organization
JOHN PATRICK WALKER MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PATRICK WALKER M.D. (OWNER)
(936) 544-7757
Entity
Organization
Contact information
Practice address
200 RENAISSANCE WAY, SUITE 100, CROCKETT, TX 75835-1772
(936) 544-7757
(936) 545-0952
Mailing address
200 RENAISSANCE WAY, SUITE 100, CROCKETT, TX 75835-1772
(936) 544-7757
(936) 545-0952
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G0254
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00QK5
MEDICARE ID
TX
05
—
035486201
—
TX
Enumeration date
12/21/2011
Last updated
02/09/2012
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