# DISCOVERY MEDICAL NETWORK PORT LAVACA LLC

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

## Provider details

- **NPI number:** 1992075303
- **Authorized official:** MARK HAVINS (CEO)
- **Authorized official phone:** (806) 791-1591

## Contact information

- **Practice address:** 815 N VIRGINIA ST, PORT LAVACA, TX 77979-3025
- **Practice address phone:** (806) 791-1591
- **Mailing address:** 2950 50TH ST, LUBBOCK, TX 79413-4326
- **Mailing address phone:** (806) 791-1591

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/03/2012
- **Last updated:** 10/17/2012