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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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