Healthcare Provider Details

I. General information

NPI: 1801806021
Provider Name (Legal Business Name): PERMIAN BASIN COMMUNITY CENTERS FOR MHMR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E ILLINOIS AVE STE 200
MIDLAND TX
79701
US

IV. Provider business mailing address

401 E ILLINOIS AVE STE 200
MIDLAND TX
79701
US

V. Phone/Fax

Practice location:
  • Phone: 432-570-3333
  • Fax: 432-570-3346
Mailing address:
  • Phone: 432-570-3333
  • Fax: 432-570-3346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number StateTX

VIII. Authorized Official

Name: MRS. RAMONA THOMAS
Title or Position: DEPUTY EXECUTIVE DIRECTOR
Credential: CPA
Phone: 432-570-3333