Organization
PRIVIA MEDICAL GROUP WEST TEXAS, PLLC
Active
Other names
West Texas Health Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW KOUBA (CEO/AUTHORIZED OFFICIAL)
(325) 437-8645
Entity
Organization
Contact information
Practice address
1665 ANTILLEY RD STE 190, ABILENE, TX 79606-5249
(325) 793-5158
(325) 793-5192
Mailing address
PO BOX 5409, ABILENE, TX 79608-5409
(325) 437-8655
(325) 437-8647
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
—
—
Other
Enumeration date
07/21/2005
Last updated
10/25/2023
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