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General NPI Number Information
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NPI Number | 1164908463
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Entity Type | Organization
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Legal Business Name | RAYMOND WESTBROOK DO PA
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 520 E NORTHWEST HWY STE 102
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City | GRAPEVINE
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State | TX
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Zip | 76051
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Country | US
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Telephone | 817-328-1922
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Fax | 817-328-1933
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Provider Business Mailing Address
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Address Line | 2701 MATLOCK RD STE 105
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City | ARLINGTON
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State | TX
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Zip | 76015-2529
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Country | US
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Telephone | 817-786-3040
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Fax | 817-786-3041
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Authorized Official
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Title or Position | CREDENTIALING
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Name | STACY LYLES HAWKINS
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Credential |
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Telephone | 361-356-3110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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