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Organization
MYRNA C DE ASIS MD PA
Active
Organization
MYRNA C DE ASIS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR DESNACIDO DE ASIS (VICE-PRESIDENT, OFFICE MANAGER)
(940) 763-8077
Entity
Organization
Contact information
Practice address
1819 TENTH ST, WICHITA FALLS, TX 76301-5012
(940) 763-8077
Mailing address
PO BOX 4710, WICHITA FALLS, TX 76308
(940) 763-8077
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K4405
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164418901
—
TX
01
—
45D0942509
CLIA
TX
Enumeration date
10/04/2006
Last updated
09/01/2010
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