NPI 1346242567

Privia Medical Group West Texas, PLLC

Organisation Specialist Abilene, TX

Practice location

Address: 1665 Antilley Rd # 200, Abilene, TX 79606-5265
Phone: (325) 793-5375
Fax: (325) 793-5384
Mailing address: PO Box 5409, Abilene, TX 79608-5409

Authorised official

Name: Andrew Kouba
Title: Ceo/Authorized Official
Phone: (325) 437-8645

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1346242567
Entity type: Organization
NPI issued: 1 Jun 2005
Record last updated: 7 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.