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General NPI Number Information
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NPI Number | 1821016676
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Entity Type | Organization
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Legal Business Name | ANDRE P DESIRE, MD, PA
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 1631 11TH ST SUITE B
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4320
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Country | US
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Telephone | 940-687-5000
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Fax | 940-687-4000
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Provider Business Mailing Address
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Address Line | 1631 11TH ST SUITE B
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4320
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Country | US
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Telephone | 940-687-5000
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Fax | 940-687-4000
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUKIE DESIRE
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Credential |
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Telephone | 940-687-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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