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General NPI Number Information
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NPI Number | 1609059963
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Entity Type | Organization
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Legal Business Name | BIG COUNTRY VEIN RELIEF, LP
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Dates
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Enumeration Date | 12/10/2007
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 4716 S 14TH ST
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City | ABILENE
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State | TX
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Zip | 79605-4733
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Country | US
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Telephone | 325-795-1200
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Fax | 315-792-1202
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Provider Business Mailing Address
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Address Line | 4716 S 14TH ST
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City | ABILENE
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State | TX
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Zip | 79605-4733
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Country | US
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Telephone | 325-795-1200
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Fax | 325-795-1202
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Authorized Official
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Title or Position | PARTNER
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Name | DR. BILLY DON JONES
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Credential | MD
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Telephone | 325-795-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | E6443
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License Number State | TX
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