Organization
PHYSICIANS OF KING'S DAUGHTERS, PA
Active
Other names
King's Daughters Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA RL MINER (CREDENTIALING COORDINATOR)
(254) 298-2682
Entity
Organization
Contact information
Practice address
800 W CENTRAL TEXAS EXPY, HARKER HEIGHTS, TX 76548-1899
(254) 298-2682
(254) 778-7197
Mailing address
1905 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 298-2682
(254) 778-7197
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C399
GROUP MEDICARE NUMBER
TX
05
—
110836702
—
TX
Enumeration date
12/17/2012
Last updated
12/17/2012
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