# WEST TEXAS MATERNAL FETAL MEDICINE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730519331
- **Authorized official:** DR. JORGE D BLANCO M.D. (MANAGING DIRECTOR)
- **Authorized official phone:** (432) 413-9252

## Contact information

- **Practice address:** 810 N DIXIE BLVD, SUITE 109, ODESSA, TX 79761-2803
- **Practice address phone:** (432) 582-2277
- **Mailing address:** PO BOX 4123, ODESSA, TX 79760-4123
- **Mailing address phone:** (432) 582-2277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | F3413 | TX | Yes |

## Other

- **Enumeration date:** 11/18/2013
- **Last updated:** 11/18/2013