Provider Demographics
NPI:1619028180
Name:HEALTH & MEDICAL CENTER
Entity Type:Organization
Organization Name:HEALTH & MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:940-692-5666
Mailing Address - Street 1:4722 TAFT BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-4800
Mailing Address - Country:US
Mailing Address - Phone:940-692-5666
Mailing Address - Fax:940-767-3578
Practice Address - Street 1:4722 TAFT BLVD STE 3
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-4800
Practice Address - Country:US
Practice Address - Phone:940-692-5666
Practice Address - Fax:940-767-3578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00117171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty