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NPI 1750979159 · on the registry since 2021 · sole proprietor
Practice
- Address
- 412 W Panola St
Carthage, TX 75633 - Phone
- (903) 693-6791
- Fax
- (903) 693-6797
- Organisation at this address
- Brookshire Brothers Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-01-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas