Organization
108 STEPHENVILLE EMERGENCY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAXTON NEIMAN (GENERAL COUNSEL)
(817) 421-0012
Entity
Organization
Contact information
Practice address
2108 W WASHINGTON ST, STEPHENVILLE, TX 76401-3928
(817) 421-0012
(817) 421-0036
Mailing address
920 S KIMBALL AVE, 140, SOUTHLAKE, TX 76092-9016
(817) 527-3403
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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