Organization
MCH TRAUMACARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRET DAVIS (SECRETARY)
(432) 640-2414
Entity
Organization
Contact information
Practice address
540 W 5TH ST STE 330, ODESSA, TX 79761-5065
(432) 640-3445
Mailing address
540 W 5TH ST STE 330, ODESSA, TX 79761-5065
(432) 640-3445
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/12/2022
Last updated
09/26/2024
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