Provider Demographics
NPI:1295009181
Name:HERBERT L. WATKINS, MD PA
Entity Type:Organization
Organization Name:HERBERT L. WATKINS, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-717-8960
Mailing Address - Street 1:2015 MULBERRY AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2312
Mailing Address - Country:US
Mailing Address - Phone:903-717-8960
Mailing Address - Fax:903-717-8964
Practice Address - Street 1:2015 MULBERRY AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2312
Practice Address - Country:US
Practice Address - Phone:903-717-8960
Practice Address - Fax:903-717-8964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5053208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty