Icw Ta is a Medical Physician Assistant based in Wichita Falls, TX and is specialized in Medical. Icw Ta practices in Wichita Falls, TX. The NPI Number for Icw Ta is 1770660136 and holds a License No. PA00159 (Texas).
The current practice location address for Icw Ta is 1411 13Th St, Wichita Falls, TX and can be reached out via phone at 940-851-9900 and via fax at 940-851-8089.
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17262701 | 05 | TX | |
| 172462702 | 05 | TX | |
| 0056MG | 01 | TX | BCBS |
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