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General NPI Number Information
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NPI Number | 1972879179
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Entity Type | Organization
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Legal Business Name | EULESS FAMILY MEDICINE & PAIN MANAGEMENT PLLC
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Dates
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Enumeration Date | 04/01/2012
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Last Update Date | 04/01/2012
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Provider Practice Location Address
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Address Line | 910 N MAIN ST
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City | EULESS
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State | TX
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Zip | 76039-3355
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Country | US
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Telephone | 817-545-1307
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Fax | 817-545-1790
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Provider Business Mailing Address
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Address Line | 910 N MAIN ST
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City | EULESS
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State | TX
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Zip | 76039-3355
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MATT PATTON
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Credential |
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Telephone | 940-243-2789
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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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