Organization · NPI-2
Southwest Ar Medical Clinic LLC
Clinic/Center · Texarkana, AR
NPI number1144899873
StatusActive
Last updated in NPPESJun 17, 2021
Details
- NPI
- 1144899873
- Entity type
- Organization (NPI-2)
- Legal business name
- Southwest Ar Medical Clinic LLC
- Organization subpart
- No
- Enumeration date
- Jun 17, 2021
- Certification date
- Jun 17, 2021
- Last updated
- Jun 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
1205 E 35th StTexarkana, AR 71854-2746
Phone 610-554-3274
Mailing address
7804 Nile AveTexarkana, TX 75503-1303
Phone 610-554-3274
Authorized official
Cassondra Houser
Vp
6105543274
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