Avanti Ayush

NPI #1528337847 in Fort Stockton, Texas

Provider Information

NPI Number
1528337847
Entity Type
Organization
Organization Name
Avanti Ayush
Primary Specialty
Internal Medicine
Enumeration Date
Dec 15, 2011
Last Updated
Dec 15, 2011

Practice Location

Address
237 W 21ST ST
State
Texas
ZIP Code
79735-2531
Phone
(432) 336-0700

Authorized Official

Name
DR. SUBODHU MALLIK, MD
Title
MEDICAL DIRECTOR
Phone
(432) 336-0700

Specialties & Taxonomy Codes

Specialty
Internal Medicine

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