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NPI Code Detail

MEDICARE: DEWITT MEDICAL DISTRICT

MEDICARE: DEWITT MEDICAL DISTRICT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QR1300XRural Health Clinic/CenterTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821422551
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEWITT MEDICAL DISTRICT
Provider Business Mailing Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-9230
Fax Number :
Provider Business Practice Location Address
First Line : 508 N RIEDEL ST
Second Line :
City : YORKTOWN
State : TX
Zip : 78164-1810
Country : US
Telephone Number : 361-564-9230
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : GREG S PRITCHETT
Credential :
Telephone Number : 361-275-6191
Provider Enumeration Date : 08/29/2013
Last Update Date : 04/21/2021

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Directions to “DEWITT MEDICAL DISTRICT ” Practice Location

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