Privia Medical Group West Texas, Pllc

NPI #1497755235 in Abilene, Texas

Provider Information

NPI Number: 1497755235
Entity Type: Organization
Organization Name: Privia Medical Group West Texas, Pllc
Primary Specialty: Specialist
Enumeration Date: Jul 22, 2005
Last Updated: Apr 5, 2022

Practice Location

Address: 1665 ANTILLEY RD
Address 2: SUITE 200
City: Abilene
State: Texas
ZIP Code: 79606-5265
Phone: (325) 437-8655

Authorized Official

Name: ANDREW KOUBA
Title: CEO/AUTHORIZED OFFICIAL
Phone: (325) 437-8645

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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