Organization
CONCHO PHYSICIAN ASSISTANT PLACEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY WOOD (MANAGER)
(325) 226-3503
Entity
Organization
Contact information
Practice address
1633 PARKVIEW DR, SAN ANGELO, TX 76904-6848
(325) 226-3503
Mailing address
PO BOX 4026, SAN ANGELO, TX 76902-4026
(325) 226-3503
(325) 617-4446
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA05955
TX
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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