PROVIDENCE HEALTH ALLIANCE NPI 1336590462

NPI Information

NPI: 1336590462
Provider Name: PROVIDENCE HEALTH ALLIANCE

Doing Business As: PROVIDENCE FAMILY HEALTH CLINIC-HILLSBORO

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
6901 MEDICAL PKWY
WACO, TX
ZIP 76712
Phone: (254) 751-4739
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PROVIDENCE HEALTH ALLIANCE is a rural health clinic center in Waco, TX. PROVIDENCE HEALTH ALLIANCE NPI is 1336590462. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence Family Health Clinic-hillsboro.

The provider's business location address is:

6901 MEDICAL PKWY
WACO, TX
ZIP 76712-910
Phone: (254) 751-4739

The provider's authorized official is Karen Richardson .
The authorized official title is Sr Vp/cfo and has the following contact phone number (254) 751-4172.

The enumeration date for this NPI number is 6/30/2016 and was last updated on 6/30/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	458913	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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