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General NPI Number Information
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NPI Number | 1689955767
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Entity Type | Organization
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Legal Business Name | ANESIA K. GARMON, DO PA
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 902 FOSTER LN
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City | WEATHERFORD
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State | TX
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Zip | 76086-5714
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Country | US
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Telephone | 817-341-7626
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Fax | 817-596-9771
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Provider Business Mailing Address
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Address Line | 902 FOSTER LN
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City | WEATHERFORD
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State | TX
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Zip | 76086-5714
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Country | US
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Telephone | 817-341-7626
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Fax | 817-596-9771
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ANESIA KHVOROFF GARMON
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Credential | DO
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Telephone | 817-341-7626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E3278
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License Number State | TX
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