Healthcare Provider Details

I. General information

NPI: 1588851240
Provider Name (Legal Business Name): GENTLE BEGINNINGS BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 HARWOOD CT
HURST TX
76054-3190
US

IV. Provider business mailing address

1817 HARWOOD CT
HURST TX
76054-3190
US

V. Phone/Fax

Practice location:
  • Phone: 817-479-0124
  • Fax: 817-428-9451
Mailing address:
  • Phone: 817-479-0124
  • Fax: 817-428-9451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number008494
License Number StateTX

VIII. Authorized Official

Name: MRS. ANN CROWELL
Title or Position: CLINICAL DIRECTOR/ MIDWIFE
Credential: CPM, LM
Phone: 817-479-0124