Healthcare Provider Details

I. General information

NPI: 1215075734
Provider Name (Legal Business Name): PLAINVIEW FOUNDATION FOR RURAL HEALTH ADVANCEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 11/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 SECOND STREET P.O. 727
HART TX
79043
US

IV. Provider business mailing address

708 SECOND STREET P.O. BOX 727
HART TX
79043
US

V. Phone/Fax

Practice location:
  • Phone: 806-938-2299
  • Fax: 806-938-2299
Mailing address:
  • Phone: 806-938-2299
  • Fax: 806-938-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number004447
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number15727
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number14975
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number0009405
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number222624
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ2653
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ8480
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ5095
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL5161
License Number StateTX
# 10
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD6154
License Number StateTX
# 11
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK7364
License Number StateTX

VIII. Authorized Official

Name: MRS. RETTA KNOX
Title or Position: PROGRAM DIRECTOR
Credential: R.N.
Phone: 806-938-2299