Organization
DISCOVERY MEDICAL NETWORK PORT LAVACA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HAVINS (CEO)
(806) 791-1591
Entity
Organization
Contact information
Practice address
815 N VIRGINIA ST, PORT LAVACA, TX 77979-3025
(806) 791-1591
Mailing address
2950 50TH ST, LUBBOCK, TX 79413-4326
(806) 791-1591
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
01/03/2012
Last updated
10/17/2012
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