Individual
EVANGELINE SOSA BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2450 NW LOOP 338, ODESSA, TX 79763-3201
(432) 332-2695
(432) 332-2665
Mailing address
PO BOX 2129, ODESSA, TX 79760-2129
(432) 640-2408
(432) 640-4606
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
512262
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207178901
—
TX
Enumeration date
01/29/2007
Last updated
07/29/2014
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