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General NPI Number Information
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NPI Number | 1881835320
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Entity Type | Organization
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Legal Business Name | WOLSKI MEDICAL
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 2436 S I-35 E SUITE 336
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City | DENTON
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State | TX
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Zip | 76205-4992
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Country | US
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Telephone | 940-484-7000
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Fax | 940-312-4086
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Provider Business Mailing Address
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Address Line | 2436 S I-35 E SUITE 336
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City | DENTON
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State | TX
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Zip | 76205-4992
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Country | US
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Telephone | 940-484-7000
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Fax | 940-312-4086
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Authorized Official
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Title or Position | HUMAN RESOURCE DIRECTOR
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Name | MS. GRETCHEN DEEANN ROACH
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Credential |
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Telephone | 940-320-6732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | F7964
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License Number State | TX
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