Healthcare Provider Details

I. General information

NPI: 1912091778
Provider Name (Legal Business Name): COMPLETE HEALTHCARE SERVICES RHC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W HOUSTON ST
JASPER TX
75951
US

IV. Provider business mailing address

315 W HOUSTON ST
JASPER TX
75951-4013
US

V. Phone/Fax

Practice location:
  • Phone: 409-384-3430
  • Fax: 409-383-0571
Mailing address:
  • Phone: 409-384-3430
  • Fax: 409-383-0571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number458910
License Number StateTX

VIII. Authorized Official

Name: KAREN C GARCIA
Title or Position: CREDENTIALLING COORDINATOR
Credential:
Phone: 409-384-3430