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General NPI Number Information
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NPI Number | 1659380418
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Entity Type | Individual
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Provider Name | VIRGINIA LYNN RAUTH MD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 701 W 5TH ST TEXAS TECH UNIVERSITY HEALTH SCI CTR/PERMIAN BASIN
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City | ODESSA
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State | TX
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Zip | 79763-4206
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Country | US
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Telephone | 432-335-5200
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Fax | 432-335-5240
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Provider Business Mailing Address
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Address Line | 701 W 5TH ST TEXAS TECH UNIVERSITY HEALTH SCI CTR/PERMIAN BASIN
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City | ODESSA
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State | TX
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Zip | 79763-4206
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Country | US
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Telephone | 432-335-5200
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Fax | 432-335-5240
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E8837
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License Number State | TX
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