Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-08-31
- Last updated
- 2020-08-22
Specialties
Licenses
- License TX
- 117604
Location
- Practice location
- 850 COUNTY ROAD 6612
- City
- DEVINE TX
- Postal code
- 780164161
- Phone
- 830-665-9678
Organization contact
- Name
- IRMA REDMAN
- Title
- Owner
- Phone
- 8306659678
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.