MODOC FAMILY MEDICINE
Marriage and Family Therapists at Central Texas Expy, Killeen, TX

License number
Texas N9415
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: DR. JEREMY LLOYD SWAIN D.O.
Title: OWNER
Phone: (254) 833-8456
Address
Address
300 W Central Texas Expy SUITE 117, Killeen, TX 76548
National Provider ID: 1407128267
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MODOC FAMILY MEDICINE, PLLC

300 W Central Texas Expy STE 117, Harker Heights, TX 76548

Doing business as:
Modoc Family Medicine, Pllc
Registration:
Jan 27, 2012
State ID:
0801542396
Business type:
Domestic Limited Liability Company (LLC)
MANAGER, Director, Manager:
Jeremy L Swain (MANAGER, Director, Manager), 300 W Central Texas Expy STE 117, Harker Heights, TX 76548
Agent:
Jeremy L. Swain,300 W Central Texas Expy, Harker Heights, TX 76548 (Physical)
TIN:
32046757384

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