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General NPI Number Information
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NPI Number | 1558546960
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Entity Type | Organization
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Legal Business Name | ROY B KENDRICK MD PA
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 1025 S 3RD ST
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City | CANADIAN
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State | TX
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Zip | 79014-3047
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Country | US
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Telephone | 806-323-8882
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Fax | 806-323-6108
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Provider Business Mailing Address
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Address Line | 1025 S 3RD ST
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City | CANADIAN
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State | TX
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Zip | 79014-3047
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Country | US
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Telephone | 806-323-8882
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Fax | 806-323-6108
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROY B KENDRICK
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Credential | MD
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Telephone | 806-323-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | L7447
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License Number State | TX
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