Healthcare Provider Details

I. General information

NPI: 1518978618
Provider Name (Legal Business Name): MIDLAND WOMEN'S CLINIC P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 WEST ILLINOS SUITE 100
MIDLAND TX
79701-4866
US

IV. Provider business mailing address

2500 WEST ILLINOIS STE 100
MIDLAND TX
79701-4866
US

V. Phone/Fax

Practice location:
  • Phone: 432-699-2370
  • Fax: 432-697-3524
Mailing address:
  • Phone: 432-699-2370
  • Fax: 432-697-3524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. NORMA GARZA
Title or Position: INSURANCE BILLER
Credential:
Phone: 432-699-2370