Healthcare Provider Details

I. General information

NPI: 1821461799
Provider Name (Legal Business Name): ADULT MEDICAL SOLUTIONS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 CROCKETT DR
BROWNWOOD TX
76801-5980
US

IV. Provider business mailing address

PO BOX 2316
BROWNWOOD TX
76804-2316
US

V. Phone/Fax

Practice location:
  • Phone: 325-643-5521
  • Fax: 325-643-2647
Mailing address:
  • Phone: 325-643-5521
  • Fax: 325-643-2647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberG6479
License Number StateTX

VIII. Authorized Official

Name: DR. GARY N BUTKA
Title or Position: OWNER
Credential: MD
Phone: 325-643-5521