Provider Demographics
NPI:1881835320
Name:WOLSKI MEDICAL
Entity Type:Organization
Organization Name:WOLSKI MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:DEEANN
Authorized Official - Last Name:ROACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-320-6732
Mailing Address - Street 1:2436 S I-35 E
Mailing Address - Street 2:SUITE 336
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4992
Mailing Address - Country:US
Mailing Address - Phone:940-484-7000
Mailing Address - Fax:940-312-4086
Practice Address - Street 1:2436 S I-35 E
Practice Address - Street 2:SUITE 336
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4992
Practice Address - Country:US
Practice Address - Phone:940-484-7000
Practice Address - Fax:940-312-4086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7964261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center