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NPI Code Detail

MEDICARE: COMPREHENSIVE INJURY TREATMENT SERVICES PLLC

MEDICARE: COMPREHENSIVE INJURY TREATMENT SERVICES PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083P0500XPreventive Medicine/Occupational Environmental Medicine PhysicianP1691TX
2208D00000XGeneral Practice PhysicianP1691TX

General Provider Information

NPI Number : 1811325954
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE INJURY TREATMENT SERVICES PLLC
Provider Business Mailing Address
First Line : 1602 W AVENUE A STE B
Second Line :
City : TEMPLE
State : TX
Zip : 76504-4080
Country : US
Telephone Number : 254-778-6474
Fax Number : 254-778-6491
Provider Business Practice Location Address
First Line : 61 N KEGLEY RD
Second Line :
City : TEMPLE
State : TX
Zip : 76502-4067
Country : US
Telephone Number : 254-778-6474
Fax Number : 254-778-6491
Authorized Official
Title or Position : BILLING MANAGER
Name : PHILIP FULTON
Credential :
Telephone Number : 254-335-0284
Provider Enumeration Date : 10/29/2013
Last Update Date : 05/26/2026

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Directions to “COMPREHENSIVE INJURY TREATMENT SERVICES PLLC ” Practice Location

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