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General NPI Number Information
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NPI Number | 1982097382
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Entity Type | Organization
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Legal Business Name | MEDICLINKMD ONE-P LLC
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 415 E SOUTHLAKE BLVD SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6250
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Country | US
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Telephone | 254-644-7898
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Fax |
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Provider Business Mailing Address
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Address Line | 415 E SOUTHLAKE BLVD SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6250
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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 | PRESIDENT
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Name | MR. ARTHUR HOHENBERGER
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Credential |
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Telephone | 254-644-7898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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