Avanti-Ayush, LLC
NPI #1992252431 in Fort Stockton, Texas
Provider Information
- NPI Number
- 1992252431
- Entity Type
- Organization
- Organization Name
- Avanti-Ayush, LLC
- Primary Specialty
- Case Management
- Enumeration Date
- Sep 1, 2016
- Last Updated
- Sep 1, 2016
Practice Location
- Address
- 237 W 21ST ST
- City
- Fort Stockton
- State
- Texas
- ZIP Code
- 79735-2536
- Phone
- (432) 290-2510
Authorized Official
- Name
- SUBODH MALLIK, M.D.
- Title
- OWNER
- Phone
- (432) 290-2510
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Management |
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