Waco Functional Medicine, Pa

NPI 1093016826 - Family Medicine - 207Q00000X

NPI Details
NPI 1093016826
Enumeration Date 11/10/2010
Last Updated 11/10/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name LISA J LISA
Position OWNER
Phone (254) 776-8009
Fax
Practice Location
318 RICHLAND WEST CIR STE B
WACO TX, 76712-7919, US
Phone (254) 776-8009
Fax
Business Location
318 RICHLAND WEST CIR STE B
WACO TX, 76712-7919, US
Phone (254) 776-8009
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Texas
License Number K3775
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According to our database, Waco Functional Medicine, Pa NPI is 1093016826, taxonomy code is 207Q00000X and license number is K3775, license state is located at Texas. Waco Functional Medicine, Pa physically located at 318 Richland West Cir Ste B, Waco TX, 76712-7919. NPI Number 1033115704 has the healthcare provider type.

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1093016826 NPI number is provided on an as is basis without warranty of any kind. 1093016826 is maintained by the National Plan & Provider Enumeration System. The contents of Waco Functional Medicine, Pa are for informational purposes only.