Doctor Name: | MR. MILTON ODIWUOR TOGO |
NPI Number: | 1245629328 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | PA07872 |
Business Practice Address: | Rr 2 Box 4400 Gatesville, TX - 765970001 |
Business Phone Number: | 2548656663 |
Business Fax Number: | |
Mailing Address: | 5210 Bagby Ave Apt 536, WACO |
State: | TX |
Postal Code: | 767112313 |
Phone Number: | 8176585719 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2015 |
NPI Last Update Date: | 01/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA07872 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |