Organization
CORNELIA S DERIESE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORNELIA S DERIESE MD PA (OWNER)
(888) 753-5988
Entity
Organization
Contact information
Practice address
3814 24TH ST, LUBBOCK, TX 79410-1814
(806) 553-7950
(623) 777-4593
Mailing address
2708 27TH ST, LUBBOCK, TX 79410-2229
(888) 753-5988
(623) 777-4593
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L6348
TX
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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