Healthcare Provider Details

I. General information

NPI: 1962483586
Provider Name (Legal Business Name): SEARS METHODIST CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 HOSPITAL DR
ABILENE TX
79606-5252
US

IV. Provider business mailing address

1 VILLAGE DR SUITE 400
ABILENE TX
79606-8231
US

V. Phone/Fax

Practice location:
  • Phone: 325-691-5519
  • Fax: 325-698-4582
Mailing address:
  • Phone: 325-691-5519
  • Fax: 325-698-4582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number113409
License Number StateTX

VIII. Authorized Official

Name: MR. RANDALL CROSSWHITE
Title or Position: VICE PRESIDENT/ASST. CFO
Credential: CPA
Phone: 325-691-5519