Vidor Community Health Clinic Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

561872 Issued in TX

Legal business name

VIDOR COMMUNITY HEALTH CLINIC INC

Practice address

1290 Highway 12
Vidor, TX 77662-4016

Phone

(409) 769-7795

Fax

(409) 769-8721

NPI assigned

Jul 30, 2006

Last updated

Feb 19, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Linda J Boone, APN

Title

President

Phone

(409) 769-7795

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donna L Zollers, NP

  • Family Medicine Physician
  • Nederland, TX
  • NPI 1659542868
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266537600000",
    "number": "1487669073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2202",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776702202",
            "telephone_number": "409-769-7795",
            "fax_number": "409-769-8721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 HIGHWAY 12",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776624016",
            "telephone_number": "409-769-7795",
            "fax_number": "409-769-8721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDOR COMMUNITY HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2010-02-19",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-769-7795",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "561872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "00037H",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119735203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "RU0016",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• TMC Provider Group, PLLC (Texas MedClinic)
• Triple D Counseling, PLL
• Fre'Daiza La'Shon Tucker
• Tyler County Hospital District (Oakwood Manor Nursing Home)
• Urgent Care of Vidor
• Vidor Dental PLLC
• Vidor Isd
• Vidor Manor Inc (Legacy Living Centers)
• Vidor Manor Nursing Home Inc (Legacy Living Centers)
• Vidor Tso PA

• Family Nurse Practitioner in Vidor, TX
• Providers in Vidor, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.