Healthcare Provider Details

I. General information

NPI: 1750622296
Provider Name (Legal Business Name): CALLAHAN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W 4TH ST SUITE 200
BAIRD TX
79504-5326
US

IV. Provider business mailing address

100 W 4TH ST SUITE 200
BAIRD TX
79504-5326
US

V. Phone/Fax

Practice location:
  • Phone: 325-854-5805
  • Fax: 325-854-5806
Mailing address:
  • Phone: 325-854-5805
  • Fax: 325-854-5806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: BRANDY KIRKLAND
Title or Position: COORDINATOR
Credential:
Phone: 325-854-5805