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General NPI Number Information
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NPI Number | 1477330405
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Entity Type | Organization
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Legal Business Name | TRUSTED HEARTS HEALTH SERVICES, PLLC
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 1613 E MAIN ST STE C
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City | MADISONVILLE
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State | TX
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Zip | 77864-2207
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Country | US
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Telephone | 936-241-5060
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Fax | 936-241-5065
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Provider Business Mailing Address
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Address Line | PO BOX 837
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City | HOWE
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State | TX
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Zip | 75459-0837
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Country | US
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Telephone | 936-241-5060
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Fax | 936-241-5065
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | JUD HUMPHRIES
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Credential | FNP
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Telephone | 936-241-5060
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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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