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Joanna Lynn Riley
Multi-Specialty Clinic/Center in Odessa, Texas
NPI 1346507209

Joanna Lynn Riley is a Multi-Specialty Clinic/Center based in Odessa, TX and is specialized in Multi-Specialty. Joanna Lynn Riley practices in Odessa, TX. The NPI Number for Joanna Lynn Riley is 1346507209 and holds a License No. 109122 (Texas).

The current practice location address for Joanna Lynn Riley is 2760 N Grandview Ave, Odessa, TX and can be reached out via phone at 432-552-7034 and via fax at 432-552-7165.

Location: 2760 N Grandview Ave, Odessa, TX, 79768-4774
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1346507209
Provider Name
Joanna Lynn Riley
Credential
Provider Entity Type
Organization
Address
2760 N Grandview Ave, Odessa, TX, 79768-4774
Phone Number
432-552-7034
Fax Number
432-552-7165
Provider Enumeration Date
04/17/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1255617270 01 TX TYPE 1 NPI
institution
Provider Business Practice Location Address Details
Address
2760 N Grandview Ave
City
Odessa
State
Texas
Zip
79762-6953
Phone Number
432-552-7034
Fax Number
432-552-7165
person
Provider Business Mailing Address Details
Address
2760 N Grandview Ave
City
Odessa
State
Texas
Zip
79762-6953
Phone Number
432-552-7034
Fax Number
432-552-7165
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
109122 (Texas)
Definition
Definition to come...
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