Healthcare Provider Details

I. General information

NPI: 1659461788
Provider Name (Legal Business Name): JASPER NEWTON COUNTY PUBLIC HEALTH DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 WEST LAMAR ST.
JASPER TX
75951-4014
US

IV. Provider business mailing address

139 WEST LAMAR ST.
JASPER TX
75951-4014
US

V. Phone/Fax

Practice location:
  • Phone: 409-384-6829
  • Fax: 409-384-4770
Mailing address:
  • Phone: 409-384-6829
  • Fax: 409-384-4770

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: MR. DANNY BRACKIN
Title or Position: INTERIM MANAGER
Credential: CPA
Phone: 409-384-6829