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General NPI Number Information
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NPI Number | 1124333414
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Entity Type | Organization
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Legal Business Name | C H WILKINSON PHYSICIAN NETWORK
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 1602 E HOUSTON ST STE C
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City | BEEVILLE
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State | TX
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Zip | 78102-5326
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Country | US
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Telephone | 361-358-9200
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Fax | 361-362-1671
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Provider Business Mailing Address
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Address Line | 919 HIDDEN RDG 6TH FLOOR
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City | IRVING
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State | TX
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Zip | 75038-3813
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Country | US
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Telephone | 469-282-2711
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Fax | 469-282-4609
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | PETER J PLANTES
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Credential | M.D.
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Telephone | 469-282-2613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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