Organization Name: | MELISSA ALWORTH D.O. P.A. |
NPI Number: | 1104193721 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELISSA D ALWORTH (PRESIDENT) |
Mailing Address: | 4519 N Garfield Suite 15 Midland |
State: | TX US |
Postal Code: | 797053400 |
Phone Number: | 4326990952 |
Fax Number: | |
NPI Enumeration Date: | 11/28/2011 |
NPI Last Update Date: | 03/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | L6763 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |