Provider Demographics
NPI:1740431055
Name:RICHARD W HOEFELMANN MD PA
Entity Type:Organization
Organization Name:RICHARD W HOEFELMANN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESTIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:HOEFELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-325-0743
Mailing Address - Street 1:100 EAST HUBBARD
Mailing Address - Street 2:STE 103
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-5320
Mailing Address - Country:US
Mailing Address - Phone:940-325-0743
Mailing Address - Fax:940-325-9617
Practice Address - Street 1:100 E HUBBARD ST
Practice Address - Street 2:STE 103
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-5320
Practice Address - Country:US
Practice Address - Phone:940-325-0743
Practice Address - Fax:940-325-9617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7783207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB23531Medicare UPIN