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Organization
MDOC HEALTH SERVICES,LLC
Active
Organization
MDOC HEALTH SERVICES,LLC
Active
Other names
CLINICA HISPANA ABILENE
Organization subpart
No
Provider details
NPI number
Authorized official
ALIESKI MASTRAPA DOMINGUEZ (MEMBER)
(281) 381-6190
Entity
Organization
Contact information
Practice address
4371 S 1ST ST, ABILENE, TX 79605-1469
(325) 701-4082
(325) 701-4081
Mailing address
PO BOX 2799, PORTER, TX 77365-2799
(281) 381-6190
(281) 747-7162
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/14/2022
Last updated
04/15/2022
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