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General NPI Number Information
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NPI Number | 1609818053
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Entity Type | Organization
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Legal Business Name | DAILEY MEDICAL CLINIC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 1108 S BUFFALO ST
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City | CANTON
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State | TX
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Zip | 75103-2304
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Country | US
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Telephone | 903-567-1910
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Fax | 903-567-1497
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Provider Business Mailing Address
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Address Line | PO BOX 788
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City | CANTON
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State | TX
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Zip | 75103-0788
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Country | US
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Telephone | 903-567-1910
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Fax | 903-567-1497
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BETTY M MCCANN
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Credential |
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Telephone | 903-567-1910
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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 | K3567
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License Number State | TX
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