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General NPI Number Information
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NPI Number | 1891859021
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Entity Type | Organization
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Legal Business Name | H AND T FAMILY HEALTHCARE CLINIC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 MERCY LANE SUITE 301
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City | HOT SPRINGS
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State | AR
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Zip | 71913
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Country | US
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Telephone | 501-627-3388
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Fax | 501-623-3899
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Provider Business Mailing Address
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Address Line | 1 MERCY LANE SUITE 301
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City | HOT SPRINGS
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State | AR
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Zip | 71913
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Country | US
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Telephone | 501-627-3388
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Fax | 501-623-3899
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Authorized Official
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Title or Position | OWNER
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Name | PRISCILLA LIZELLE H TANGUNAN
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Credential | MD
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Telephone | 501-623-3388
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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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