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General NPI Number Information
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NPI Number | 1295815827
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER CLINIC OF ANGLETON, P.A.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 135 E HOSPITAL DR
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City | ANGLETON
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State | TX
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Zip | 77515
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Country | US
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Telephone | 979-849-7795
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Fax | 979-849-5905
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Provider Business Mailing Address
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Address Line | 135 E HOSPITAL DR
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City | ANGLETON
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State | TX
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Zip | 77515
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Country | US
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Telephone | 979-849-7795
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Fax | 979-849-5905
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS FERNANDO TSCHEN
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Credential |
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Telephone | 979-849-7795
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K7405
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License Number State | TX
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