Individual
BERNICE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2200 W ILLINOIS AVE, MIDLAND, TX 79701-6407
(432) 685-1111
Mailing address
PO BOX 5718, NORMAN, OK 73070-5718
(866) 321-8433
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
H9489
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140270338
—
TX
Enumeration date
08/24/2005
Last updated
09/18/2015
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