Organization · Type 2 NPI
Icw Ta
Medical Physician Assistant · Wichita Falls, TX
NPI number
1770660136
Active
Practice location
1411 13th St
Wichita Falls, TX 76301-7100
Fax (940) 851-8089
Mailing address
1411 13th St Ste 2
Wichita Falls, TX 76301-7100
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA00159 (TX) |
Medical Physician Assistant: Definition to come...
About NPI 1770660136
Icw Ta's National Provider Identifier is 1770660136, issued on Nov 1, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Wichita Falls, TX. The record was last updated on Nov 6, 2008.