| Kim Lisa Bango Md Pa | |
|
1608 W Fm 700 Suite D Big Spring TX 79720-4105 | |
| (432) 263-0500 | |
| (432) 263-0501 |
| Full Name | Kim Lisa Bango Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1608 W Fm 700, Big Spring, Texas |
| Authorized Official Name and Position | Kim Lisa Bango (OWNER) |
| Authorized Official Contact | 4322630500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Lisa Bango Md Pa 1608 W Fm 700 Suite D Big Spring TX 79720-4105 Ph: (432) 263-0500 | Kim Lisa Bango Md Pa 1608 W Fm 700 Suite D Big Spring TX 79720-4105 Ph: (432) 263-0500 |
| NPI Number | 1477595866 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 04/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477595866 | NPI | - | NPPES |
| 182593701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M3462 (Texas) | Primary |
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