Organization
FATHER OF WATERS EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(954) 838-2371
Entity
Organization
Contact information
Practice address
14365 HIGHWAY 16 W, DE KALB, MS 39328-7974
(800) 444-7009
Mailing address
13737 NOEL RD, STE 1600, DALLAS, TX 75240-1331
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
01/21/2011
Last updated
08/25/2019
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