Organization
PHYSICIANS OF KING'S DAUGHTERS, PA
Active
Other names
King's Daughters Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA RL MINER (CREDENTIALING COORDINATOR)
(254) 298-2682
Entity
Organization
Contact information
Practice address
2025 MEMORY LN, SUITE 500, HARKER HEIGHTS, TX 76548-7487
(254) 298-2682
(254) 778-7197
Mailing address
1905 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 298-2682
(254) 778-7197
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C399
GROUP MEDICARE NUMBER
TX
01
—
110836702
GROUP MEDICAID NUMBER
TX
Enumeration date
12/17/2012
Last updated
12/17/2012
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