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Indavong Phonasa, FNP-C
Family Nurse Practitioner in Odessa, Texas
NPI 1912356130

Indavong Phonasa is a Family Nurse Practitioner based in Odessa, TX and is specialized in Family. Indavong Phonasa practices in Odessa, TX and has the professional credentials of FNP-C. The NPI Number for Indavong Phonasa is 1912356130 and holds a License No. AP131078 (Texas).

The current practice location address for Indavong Phonasa is 605 E 4Th St, Odessa, TX and can be reached out via phone at 432-337-4347.

Location: 605 E 4Th St, Odessa, TX, 79761-5100
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912356130
Provider Name
Indavong Phonasa
Credential
FNP-C
Provider Entity Type
Individual
Gender
Male
Address
605 E 4Th St, Odessa, TX, 79761-5100
Phone Number
432-337-4347
Fax Number
Provider Enumeration Date
06/08/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
605 E 4Th St
City
Odessa
State
Texas
Zip
79761-5100
Phone Number
432-337-4347
Fax Number
person
Provider Business Mailing Address Details
Address
605 E 4Th St
City
Odessa
State
Texas
Zip
79761-5100
Phone Number
432-337-4347
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
AP131078 (Texas)
Definition
Definition to come...
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