NPI | 1164819603 |
---|---|
Doing Business As | CONCHO VALLEY OB-GYN |
Entity Type | Organization |
Authorized Contact | JENNIFER MICHELE MOSS Sole Proprietor 325-944-9999 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX K7835) |
Enumeration Date | 2015-04-22 |
Last Update Date | 2015-09-29 |