Gwenvolk Infocus Inc

Organization Active NPI Medical Physician Assistant · Waskom, TX

NPI 1992928428 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1992928428
Entity type
Organization (NPI type 2)
Primary specialty
Medical Physician Assistant 363AM0700X
License
PA0126 (TX)
Legal business name
GWENVOLK INFOCUS INC
Practice address
390 W Texas Ave
Waskom, TX 75692-9113
Phone
(903) 687-2500
Fax
(903) 687-3510
NPI assigned
Apr 11, 2007
Organization subpart
No

Authorized official

Name
Mr. Kenneth L Volk, PA C
Title
Owner Director
Phone
(903) 687-2500

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Affordable Health Care Clinic (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
363AM0700X PA0126 TX 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 identifiers

IdentifierTypeStateIssuer
1861484818OtherTXINDIVIDUAL NPI

Other names

  • AFFORDABLE HEALTH CLINIC Doing business as

Other providers in Waskom, TX

All providers in Waskom, TX · Medical Physician Assistant in Texas

Sources for this page

Verify at the official NPI Registry.