Organization
DENTON COLON AND RECTAL SURGERY, P.A.
Active
Organization
DENTON COLON AND RECTAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA A. PROVOST MD (DIRECTOR)
(940) 383-2424
Entity
Organization
Contact information
Practice address
1300 FULTON ST, SUITE 203, DENTON, TX 76201-2688
(940) 383-2424
(940) 387-5676
Mailing address
1300 FULTON ST, SUITE 203, DENTON, TX 76201-2688
(940) 383-2424
(940) 387-5676
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
M2618
TX
Other
Enumeration date
06/21/2006
Last updated
04/29/2008
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