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General NPI Number Information
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NPI Number | 1649599556
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Entity Type | Organization
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Legal Business Name | MEDICAL AND SURGICAL ASSOCIATES OF CORSICANA
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 505 N HIGHWAY 77 SUITE 200
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City | WAXAHACHIE
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State | TX
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Zip | 75165-1128
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Country | US
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Telephone | 972-923-1686
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Fax | 972-937-7731
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Provider Business Mailing Address
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Address Line | 401 HOSPITAL DR SUITE 120
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City | CORSICANA
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State | TX
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Zip | 75110-2415
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Country | US
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Telephone | 903-872-3005
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Fax | 903-872-3050
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Authorized Official
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Title or Position | ADMINISTATOR
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Name | MR. RONNIE L RAGSDALE
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Credential |
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Telephone | 903-872-3005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | E2721
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License Number State | TX
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