NPIMap

Organization Active NPI

Scott & White Clinic

  • Clinical Medical Laboratory
  • Brenham, TX
National Provider Identifier
1710468012
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SCOTT & WHITE CLINIC
Practice address
600 N Park St
Brenham, TX 77833-2610
Phone
(979) 836-6153
NPI assigned
Aug 24, 2018
Last updated
Aug 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Authorized official

Name
Alice Cantu
Title
System Director, CBS
Phone
(254) 215-9719

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

600 N Park St
Brenham, TX 77833-2610

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181018001450 TX Part B Supplier - Independent Clinical Laboratory 8123923604 Practice locations: Brenham, TX

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1710468012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N PARK ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778332610",
            "telephone_number": "979-836-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT & WHITE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "CANTU",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR, CBS",
        "authorized_official_telephone_number": "254-215-9719"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.