Healthcare Provider Details

I. General information

NPI: 1649468422
Provider Name (Legal Business Name): SUE D. RHINEHART
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 06/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 E 4TH ST
CLARENDON TX
79226-6102
US

IV. Provider business mailing address

216 E 4TH ST
CLARENDON TX
79226-6102
US

V. Phone/Fax

Practice location:
  • Phone: 806-874-5000
  • Fax:
Mailing address:
  • Phone: 806-874-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: SUE D. RHINEHART
Title or Position: SOLE PROPRIETOR
Credential:
Phone: 806-874-5000