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General NPI Number Information
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NPI Number | 1285724435
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Entity Type | Organization
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Legal Business Name | HEART OF TEXAS INTERNAL MEDICINE ASSOCIATES, PA
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 902 WEST COLLEGE
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City | RISING STAR
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State | TX
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Zip | 76471-5143
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Country | US
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Telephone | 254-643-3141
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Fax | 254-643-4000
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Provider Business Mailing Address
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Address Line | PO BOX 520
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City | BROWNWOOD
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State | TX
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Zip | 76804-0520
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Country | US
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Telephone | 254-643-3141
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Fax | 254-643-4000
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Authorized Official
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Title or Position | CFO
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Name | BRYAN WEST
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Credential |
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Telephone | 325-643-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K4521
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License Number State | TX
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