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General NPI Number Information
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NPI Number | 1275892499
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Entity Type | Organization
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Legal Business Name | KAMAL N. TOLIA, M.D., P.A.
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 6005 EASTRIDGE RD SUITE 110
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City | ODESSA
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State | TX
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Zip | 79762-5019
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Country | US
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Telephone | 432-362-3626
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Fax | 432-366-3363
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Provider Business Mailing Address
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Address Line | 6005 EASTRIDGE RD SUITE 110
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City | ODESSA
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State | TX
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Zip | 79762-5019
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Country | US
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Telephone | 432-362-3626
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Fax | 432-366-3363
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KAMAL NALIN TOLIA
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Credential | M.D.
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Telephone | 432-362-3626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | G5697
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License Number State | TX
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