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General NPI Number Information
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NPI Number | 1407281785
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Entity Type | Organization
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Legal Business Name | MW HEALTH ASSOCIATE INC
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Dates
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Enumeration Date | 09/05/2013
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 1880 MINERAL WELLS HWY STE 107
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City | WEATHERFORD
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State | TX
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Zip | 76088-8381
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Country | US
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Telephone | 817-594-3676
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Fax |
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Provider Business Mailing Address
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Address Line | 1880 MINERAL WELLS HWY STE 107
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City | WEATHERFORD
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State | TX
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Zip | 76088-8381
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Country | US
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Telephone | 817-594-3676
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNA PENKOVA
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Credential |
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Telephone | 817-594-3676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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