Mad Dog Enterprises LP
Organization Active NPI Hospice and Palliative Medicine (Family Medicine) Physician · Waskom, TX
NPI 1114144102 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1114144102
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X
- Legal business name
- MAD DOG ENTERPRISES LP
- Practice address
- 390 W Texas Ave
Waskom, TX 75692-9113 - Phone
- (903) 687-2500
- NPI assigned
- Apr 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Kenneth Lee Volk, PA-C
- Title
- Vice President
- Phone
- (903) 687-2500
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician |
207QH0002X | Yes |
Addresses
Primary practice location
390 W Texas Ave
Waskom, TX 75692-9113
Mailing address
390 W Texas Ave
Waskom, TX 75692-9113
Phone (903) 687-2500
Other names
- Affordable Health Care Clinic
Other providers in Waskom, TX
- Gwenvolkinfocus Inc
- Alisha Denise Head
- Marcellus Perris Henderson
- Shannon Griffin Johnson
- Killion'S Pharmacy, LLC
- Veronica Rachee McCray
- McEt-Waskom Limited Liability Company
- Frank McIlwain
- Gwendolyn L McVey
- Kevin Phuong Minh Nguyen
All providers in Waskom, TX · Hospice and Palliative Medicine (Family Medicine) Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.