Organization Name: | HIGH COUNTRY COMMUNITY RURAL HEALTH CLINIC |
NPI Number: | 1699943191 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOE ANN MOORE (MANAGER) |
Mailing Address: | 201 E Texas Blvd Dalhart |
State: | TX US |
Postal Code: | 790224321 |
Phone Number: | 8062498324 |
Fax Number: | 8062498412 |
NPI Enumeration Date: | 02/19/2008 |
NPI Last Update Date: | 02/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA00540 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |