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Organization
MIDLAND MEDICAL GROUP PA
Active
Organization
MIDLAND MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA SPARKS (MANAGING EMPLOYEE)
(432) 571-7061
Entity
Organization
Contact information
Practice address
25 VILLAGE CIRCLE, MIDLAND, TX 79701
(432) 571-7016
(432) 571-7071
Mailing address
PO BOX 2080, MIDLAND, TX 79702-2080
(432) 571-7016
(432) 571-7071
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011LH
BCBS
TX
Enumeration date
03/20/2006
Last updated
08/22/2020
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