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General NPI Number Information
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NPI Number | 1992910731
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Entity Type | Organization
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Legal Business Name | TED MCLEMORE, M.D., PH.D. P A
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 1055 CLARKSVILLE ST 110
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City | PARIS
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State | TX
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Zip | 75460-6097
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Country | US
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Telephone | 903-784-7472
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Fax | 903-784-4598
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Provider Business Mailing Address
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Address Line | 1055 CLARKSVILLE ST 110
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City | PARIS
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State | TX
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Zip | 75460-6097
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Country | US
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Telephone | 903-784-7472
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Fax | 903-784-4598
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Authorized Official
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Title or Position | OWNER
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Name | DR. TED L. MCLEMORE
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Credential | M.D.
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Telephone | 903-784-7472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | F9806
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License Number State | TX
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