JACK R CHILDRESS MD
Individual Provider (NPI-1)
Active
Internal Medicine
Provider Information
- NPI Number
1841245883- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MD
- Status
- Active
Contact & Location
- Address
- 105 SEQUOYA DR, LAKE KIOWA, TX, 762409446
- Phone
- (940) 736-8885
- Fax
- (940) 668-8292
Specialties & Taxonomies
Internal Medicine
License: LA #346502
Internal Medicine
License: WY #14502A
Internal Medicine
License: GA #97208
Hospitalist
License: TX #H5535
Internal Medicine
Primary License: TX #H5535