Special Health Resources for Texas Incorporated

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SPECIAL HEALTH RESOURCES FOR TEXAS INCORPORATED

Practice address

1911 Galleria Oaks Dr
Texarkana, TX 75503-4617

Phone

(903) 792-0308

Fax

(903) 792-0007

NPI assigned

Dec 20, 2018

Organization subpart

No

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

Authorized official

Name

Kim Dale Nesvig

Title

Ceo

Phone

(903) 234-0776

Specialties & licenses 1

Addresses

Other names 1

• INTEGRATED PEDIATRIC CARE CLINIC Doing business as

Locations

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1831661412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2709",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756062709",
            "telephone_number": "903-234-0776",
            "fax_number": "903-234-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 GALLERIA OAKS DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034617",
            "telephone_number": "903-792-0308",
            "fax_number": "903-792-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL HEALTH RESOURCES FOR TEXAS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "NESVIG",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-234-0776"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRATED PEDIATRIC CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Texarkana, TX
• Federally Qualified Health Center (FQHC) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.