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General NPI Number Information
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NPI Number | 1578930053
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Entity Type | Organization
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Legal Business Name | SOUTH CAROLINA MHT LLC
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 1515 HERITAGE DR SUITE 100
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City | MCKINNEY
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State | TX
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Zip | 75069-3256
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Country | US
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Telephone | 972-616-4932
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 HERITAGE DR SUITE 100
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City | MCKINNEY
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State | TX
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Zip | 75069-3256
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Country | US
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Telephone | 972-616-4932
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Fax |
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Authorized Official
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Title or Position | CEO / OWNER
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Name | SHERMAN L POSTLE
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Credential |
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Telephone | 469-744-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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