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4096 Summerhill Sq Texarkana TX 75503-2730 | |
| (903) 255-0307 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4096 Summerhill Sq, Texarkana, Texas |
| Authorized Official Name and Position | Kim L Baggett (OFFICE MANAGER) |
| Authorized Official Contact | 9032550307 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4096 Summerhill Sq Texarkana TX 75503-2730 Ph: (903) 255-0307 | 4096 Summerhill Sq Texarkana TX 75503-2730 Ph: (903) 255-0307 |
| NPI Number | 1912196379 |
|---|---|
| Provider Enumeration Date | 10/22/2007 |
| Last Update Date | 10/22/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912196379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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