| Organization Name: | MINERAL WELLS WOMEN'S PAVILION, P.A. |
| NPI Number: | 1407070758 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM TARKENTON (OWNER) |
| Mailing Address: | 220 Sw 26th Avenue Mineral Wells |
| State: | TX US |
| Postal Code: | 76067 |
| Phone Number: | 9403281261 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 07/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | H2824 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |