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General NPI Number Information
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NPI Number | 1861521825
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Entity Type | Organization
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Legal Business Name | LARRY L. MAPLES, D.O., P.A.
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 203 S DAUGHERTY AVE
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City | EASTLAND
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State | TX
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Zip | 76448-2607
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Country | US
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Telephone | 254-631-0544
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Fax | 254-631-0026
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Provider Business Mailing Address
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Address Line | 203 S DAUGHERTY AVE
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City | EASTLAND
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State | TX
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Zip | 76448-2607
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Country | US
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Telephone | 254-631-0544
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Fax | 254-631-0426
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Authorized Official
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Title or Position | FAMILY PHYSICIAN
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Name | DR. LARRY LEN MAPLES
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Credential | D.O.
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Telephone | 254-631-0544
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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 | J0090
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License Number State | TX
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