Sour Lake Family Medical | |
517 S Hwy 326 Sour Lake TX 77659 | |
(409) 287-2762 | |
Not Available |
Full Name | Sour Lake Family Medical |
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Speciality | Family Medicine |
Location | 517 S Hwy 326, Sour Lake, Texas |
Authorized Official Name and Position | Paul Wesolow (PAUL WESOLOW MD) |
Authorized Official Contact | 4092872762 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sour Lake Family Medical Po Box 949 Sour Lake TX 77659 Ph: (409) 287-2762 | Sour Lake Family Medical 517 S Hwy 326 Sour Lake TX 77659 Ph: (409) 287-2762 |
NPI Number | 1407977960 |
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Provider Enumeration Date | 04/03/2007 |
Last Update Date | 03/06/2008 |
Identifier | Type | State | Issuer |
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1407977960 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | J1812 (Texas) | Primary |