NPI Provider: 1679554844
Contact Name: Horner L Douglas
Position: Clinic Administrator
Phone: (254) 752-2300
Sanger Avenue Medical Information:
Sanger Avenue Medical organization have npi 1679554844, taxonomy code is 291U00000X with license number is in . This Business address located in 6614 Sanger Ave, Waco, TX 76710 Texas.
Practice Location
Address: 6614 Sanger Ave, Waco, TX 76710
Phone: (254) 752-2300
Business Location
Address: 6614 Sanger Ave, Waco, TX 76710
Phone: (254) 752-2300
Fax: (254) 752-9436
Taxonomy
Taxonomy Code: 291U00000X
License Number:
License Number of State: TX
Primary Taxonomy Switch: Y
Enumeration Date: 11/7/2005
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