Healthcare Provider Details

I. General information

NPI: 1932327228
Provider Name (Legal Business Name): JASPER NEWTON COUNTY PUBLIC HEALTH DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E LAVIELLE ST
KIRBYVILLE TX
75956-2119
US

IV. Provider business mailing address

205 E LAVIELLE ST
KIRBYVILLE TX
75956-2119
US

V. Phone/Fax

Practice location:
  • Phone: 409-423-6133
  • Fax: 409-423-2623
Mailing address:
  • Phone: 409-423-6133
  • Fax: 409-423-2623

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: DIRECTOR
Credential: CPA
Phone: 409-384-6829