Provider Demographics
NPI:1912220427
Name:COMPLEAT PHYSICIANS PLLC
Entity type:Organization
Organization Name:COMPLEAT PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-772-2222
Mailing Address - Street 1:7005 WOODWAY DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712
Mailing Address - Country:US
Mailing Address - Phone:254-772-2222
Mailing Address - Fax:254-732-3661
Practice Address - Street 1:7005 WOODWAY DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:254-772-2222
Practice Address - Fax:254-732-3661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1071261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty