INDAVONG PHONASA

ODESSA, TX
NPI1912356130
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: TX  AP131078)
Enumeration Date2016-06-08
Last Update Date2016-06-08
Business Address
-- INDAVONG PHONASA FNP-C
605 E 4TH ST
ODESSA, TX 79761-5100
Phone number: 432-337-4347
Mailing Address
-- INDAVONG PHONASA FNP-C
605 E 4TH ST
ODESSA, TX 79761-5100
Phone number: 432-337-4347
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