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General NPI Number Information
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NPI Number | 1114038254
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Entity Type | Organization
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Legal Business Name | WORKERS INJURY MANAGEMENT AND EVALUATION SERVICES, P.A.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 1981 S. OLD TEMPLE ROAD
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City | LORENA
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State | TX
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Zip | 76655
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Country | US
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Telephone | 254-857-4021
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Fax | 254-857-4391
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Provider Business Mailing Address
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Address Line | 1981 S. OLD TEMPLE ROAD
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City | LORENA
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State | TX
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Zip | 76655
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Country | US
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Telephone | 254-857-4021
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Fax | 254-857-4391
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS VIRGINIA GAYLE EAST-SMITH
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Credential |
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Telephone | 254-857-4021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | J2502
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License Number State | TX
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