Provider Demographics
NPI:1184677080
Name:PALM VALLEY WOMEN'S CARE, PLC
Entity Type:Organization
Organization Name:PALM VALLEY WOMEN'S CARE, PLC
Other - Org Name:EXCEL OBSTETRICS & GYNECOLOGY, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-535-0740
Mailing Address - Street 1:10815 W MCDOWELL RD STE 301
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5016
Mailing Address - Country:US
Mailing Address - Phone:623-535-0740
Mailing Address - Fax:623-535-0741
Practice Address - Street 1:13555 W MCDOWELL RD
Practice Address - Street 2:SUITE 205
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2624
Practice Address - Country:US
Practice Address - Phone:623-535-0740
Practice Address - Fax:623-535-0741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ110355Medicare PIN