Organization
COGGIN AVENUE MEDICAL PARK PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATY M LORD (FACILITY MANAGER)
(325) 646-7828
Entity
Organization
Contact information
Practice address
2201 COGGIN AVE, BROWNWOOD, TX 76801-4734
(325) 646-7828
(325) 646-7888
Mailing address
2201 COGGIN AVE, BROWNWOOD, TX 76801-4734
(325) 646-7828
(325) 646-7888
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205587301
—
TX
Enumeration date
05/27/2009
Last updated
03/15/2011
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