CORNELIA L AGENT MD PA
Osteopathic Medicine at Blackstone Ln, Alvin, TX

License number
Texas F9123
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: CORNELIA L AGENT MD
Title: OWNER
Phone: (281) 331-5253
Address
Address
215 W Blackstone Ln, Alvin, TX 77511
National Provider ID: 1831473354
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CORNELIA L. AGENT, M.D., PA

215 W Blackstone Ln, Alvin, TX 77511

Status:
Inactive
Registration:
Dec 21, 1988
State ID:
0081181003
Business type:
Professional Association
President , Director , Member:
Cornelia L Agent President , Director , Member, inactive
Agent:
Cornelia L. Agent,215 W Blackstone, Alvin, TX 77511 (Physical)
TIN:
17602658506

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