Deweyville Rural Health Clinic LLC
Organization Active NPI Rural Health Clinic/Center · Orange, TX
NPI 1992763684 · NPPES record last updated Jul 21, 2008
Key facts
- NPI
- 1992763684
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 10-560939-6 (TX)
- Legal business name
- DEWEYVILLE RURAL HEALTH CLINIC LLC
- Practice address
- 2493 State Highway 12 E
Orange, TX 77632-8426 - Phone
- (409) 746-7000
- Fax
- (409) 746-7016
- NPI assigned
- May 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. William David Dunn, FNP
- Title
- Owner
- Phone
- (409) 746-7000
National Provider Directory
Locations
2493 State Highway 12 E
Orange, TX 77632
Phone (409) 746-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 10-560939-6 | TX | Yes |
Addresses
Primary practice location
2493 State Highway 12 E
Orange, TX 77632-8426
Mailing address
2493 State Highway 12 E
Orange, TX 77632-8426
Phone (409) 746-7000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 170485001 | Medicaid | TX |
Other names
- Deweyville Health Clinic
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.