Organization Name: | CACTUS HEALTH SERVICES INC |
NPI Number: | 1962663740 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LUIS VILLARREAL (CEO) |
Mailing Address: | 301 N Water Street Fort Stockton |
State: | TX US |
Postal Code: | 79735 |
Phone Number: | 4323368110 |
Fax Number: | 4323368107 |
NPI Enumeration Date: | 06/24/2008 |
NPI Last Update Date: | 10/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |