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General NPI Number Information
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NPI Number | 1740441302
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Entity Type | Organization
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Legal Business Name | GEORGETOWN OB GYN LLP
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 602 HIGH TECH DRIVE
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City | GEORGETOWN
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State | TX
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Zip | 78626
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Country | US
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Telephone | 512-863-8600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1223
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City | GEORGETOWN
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State | TX
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Zip | 78627-1223
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Country | US
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Telephone | 512-863-8600
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Fax | 512-863-8641
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DEBORAH S SANTIFER
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Credential | CPC
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Telephone | 512-863-8600
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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 | K7214
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | H7653
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License Number State | TX
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