Discovery Medical Network Port Lavaca LLC

Organization Active NPI Obstetrics & Gynecology Physician · Port Lavaca, TX

NPI 1992075303 · NPPES record last updated Oct 17, 2012

Key facts

NPI
1992075303
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
DISCOVERY MEDICAL NETWORK PORT LAVACA LLC
Practice address
815 N Virginia St
Port Lavaca, TX 77979-3025
Phone
(806) 791-1591
NPI assigned
Jan 3, 2012
Organization subpart
No

Authorized official

Name
Mark Havins
Title
Ceo
Phone
(806) 791-1591

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207V00000X Yes

Addresses

Primary practice location

815 N Virginia St
Port Lavaca, TX 77979-3025

Mailing address

2950 50TH St
Lubbock, TX 79413-4326
Phone (806) 791-1591

Other providers in Port Lavaca, TX

All providers in Port Lavaca, TX · Obstetrics & Gynecology Physician in Texas

Sources for this page

Verify at the official NPI Registry.