Organization
SMG SIGNATURE MEDICAL GROUP
Active
Other names
TGMA Wharton Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY SLACK (CEO)
(979) 282-6100
Entity
Organization
Contact information
Practice address
2022 REGIONAL MEDICAL DR, SUITE 1319, WHARTON, TX 77488-7231
(979) 282-6800
(979) 282-6805
Mailing address
PO BOX 841648, DALLAS, TX 75284-1648
(979) 282-6800
(979) 282-6805
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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