Healthcare Provider Details

I. General information

NPI: 1235225087
Provider Name (Legal Business Name): MIDLAND COMMUNITY HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E FLORIDA AVE
MIDLAND TX
79701-8212
US

IV. Provider business mailing address

PO BOX 5576
MIDLAND TX
79704-5576
US

V. Phone/Fax

Practice location:
  • Phone: 432-685-0450
  • Fax: 432-685-0459
Mailing address:
  • Phone: 432-570-0238
  • Fax: 432-699-3815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL AUSTIN
Title or Position: CEO
Credential: PHD
Phone: 432-570-0238