Organization
CONCHO VALLEY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN A MEJIA MD (PROVIDER)
(407) 414-6102
Entity
Organization
Contact information
Practice address
225 S ABE ST, SAN ANGELO, TX 76903-6305
(407) 414-6102
Mailing address
223 S ABE ST, SAN ANGELO, TX 76903-6305
(325) 374-0821
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P9224
TEXAS MEDICAL BOARD
TX
Enumeration date
02/24/2023
Last updated
02/24/2023
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