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General NPI Number Information
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NPI Number | 1730125865
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Entity Type | Organization
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Legal Business Name | GENE MCDANIEL DO PA
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 308 W HWY 199
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City | SPRINGTOWN
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State | TX
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Zip | 76082
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Country | US
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Telephone | 817-523-5402
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Fax | 817-523-5422
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Provider Business Mailing Address
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Address Line | PO BOX 1039
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City | SPRINGTOWN
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State | TX
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Zip | 76082
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Country | US
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Telephone | 817-523-5402
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Fax | 817-523-5422
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Authorized Official
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Title or Position | PRESIDENT
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Name | WENDELL GENE MCDANIEL
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Credential | DO
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Telephone | 817-523-5402
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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 |
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License Number State |
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