Healthcare Provider Details
I. General information
NPI: 1083832562
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
210 HIGH ST
NEWTON TX
75966-3216
US
IV. Provider business mailing address
139 WEST LAMAR ST.
JASPER TX
75951-4014
US
V. Phone/Fax
- Phone: 409-379-5291
- Fax: 409-379-3054
- Phone: 409-384-6829
- Fax: 409-384-4770
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public 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