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General NPI Number Information
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NPI Number | 1588043095
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Entity Type | Organization
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Legal Business Name | HEALTH EBEST, LLC
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 6400 COLLEYVILLE BLVD
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City | COLLEYVILLE
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State | TX
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Zip | 76034-6444
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Country | US
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Telephone | 817-416-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 COLLEYVILLE BLVD
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City | COLLEYVILLE
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State | TX
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Zip | 76034-6444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN WACASEY
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Credential | M.D.
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Telephone | 817-416-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | K3519
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License Number State | TX
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