Organization
ANDRE P DESIRE, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUKIE DESIRE (OFFICE MANAGER)
(940) 687-5000
Entity
Organization
Contact information
Practice address
1631 11TH ST, SUITE B, WICHITA FALLS, TX 76301-4320
(940) 687-5000
(940) 687-4000
Mailing address
1631 11TH ST, SUITE B, WICHITA FALLS, TX 76301-4320
(940) 687-5000
(940) 687-4000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060063342
MEDICARE B - RR
—
05
—
174352801
—
TX
Enumeration date
07/18/2006
Last updated
05/04/2011
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