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General NPI Number Information
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NPI Number | 1528407061
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Entity Type | Organization
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Legal Business Name | ML PALMER, PLLC; DBA: BOGATA HEALTH CLINIC
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 106 2ND ST NW
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City | BOGATA
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State | TX
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Zip | 75417-2451
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Country | US
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Telephone | 903-632-0078
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Fax | 903-632-1825
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Provider Business Mailing Address
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Address Line | PO BOX 367
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City | BOGATA
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State | TX
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Zip | 75417-0367
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Country | US
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Telephone | 903-632-0078
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Fax | 903-632-1825
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Authorized Official
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Title or Position | OWNER
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Name | MARY L PALMER
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Credential |
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Telephone | 903-632-0078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 606498
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License Number State | TX
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