Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Sports Medicine |
2083S0010X | 84 | Physician/Preventive Medicine |
| NPI Number | 1588030241 |
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| LBN Legal business name | TEXAS A&M UNIVERSITY | ||||||||
| Authorized official | PHIL HEDRICK - (ASSISTANT A.D. ATHLETIC TRAINING) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 08/18/2015 | ||||||||
| Last updated | 08/18/2015 - About 11 years ago | ||||||||
| Identifiers |
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TEXAS A&M UNIVERSITY
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