Healthcare Provider Details

I. General information

NPI: 1851347934
Provider Name (Legal Business Name): CORAZON P QUIROS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W 3RD ST
BORGER TX
79007-4008
US

IV. Provider business mailing address

PO BOX 5284
BORGER TX
79008-5284
US

V. Phone/Fax

Practice location:
  • Phone: 806-273-7596
  • Fax: 806-274-3622
Mailing address:
  • Phone: 806-273-7596
  • Fax: 806-274-3622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberF2384
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: