| Injury One Of Wichita Falls, Llc | |
|
2611 Plaza Pkwy Suite 302 Wichita Falls TX 76308-3886 | |
| (214) 563-5122 | |
| (214) 361-1235 |
| Full Name | Injury One Of Wichita Falls, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2611 Plaza Pkwy, Wichita Falls, Texas |
| Authorized Official Name and Position | Nat E Mangum (CEO) |
| Authorized Official Contact | 2146926666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Injury One Of Wichita Falls, Llc 5931 Desco Dr Dallas TX 75225-1604 Ph: (214) 563-5122 | Injury One Of Wichita Falls, Llc 2611 Plaza Pkwy Suite 302 Wichita Falls TX 76308-3886 Ph: (214) 563-5122 |
| NPI Number | 1154562031 |
|---|---|
| Provider Enumeration Date | 03/23/2009 |
| Last Update Date | 03/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154562031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 15520 (Texas) | Secondary |
| 103T00000X | Psychologist | 32981 (Texas) | Primary |
| 103T00000X | Psychologist | 33427 (Texas) | Secondary |
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