Individual
ALLIE CHRISTINE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3051 E UNIVERSITY BLVD, ODESSA, TX 79762-7902
(432) 362-4376
(432) 362-6308
Mailing address
3051 E UNIVERSITY BLVD, ODESSA, TX 79762-7902
(432) 362-4376
(432) 362-6308
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07554
TX
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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