Nacogdoches Internal Medicine Pllc

LBN: Nacogdoches Internal Medicine Pllc
Nacogdoches Internal Medicine Pllc is an health care organization with primary practice located at 412 North St Ste E , Nacogdoches TX 75961. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Nacogdoches Internal Medicine Pllc can be contacted via phone (936) 560-1812, or through Wilson, Walter Brad via phone (936) 560-1812.

Contact Information

Primary practice address
412 North St Ste E Nacogdoches TX 75961
Phone: (936) 560-1812
Fax: (936) 560-3070
Website:
Map and Directions
Authorized official contact:
Name: Wilson, Walter Brad Doctor of Medicine (MD)
Phone: (936) 560-1812

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X H3293 Texas

Profile Details

NPI number 1609319458
LBN Legal business name Nacogdoches Internal Medicine Pllc
DBA Doing business as
Authorized official Wilson, Walter Brad Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2016
Last updated May 21st, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609319458 NPPES
Texas MEDICAID 377530601
Texas MEDICAID 113906502

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