Healthcare Provider Details

I. General information

NPI: 1124120928
Provider Name (Legal Business Name): NEWTON FAMILY CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 09/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 EAST COURT
NEWTON TX
75966
US

IV. Provider business mailing address

207 EAST COURT
NEWTON TX
75966
US

V. Phone/Fax

Practice location:
  • Phone: 409-379-2647
  • Fax: 409-379-2698
Mailing address:
  • Phone: 409-379-2647
  • Fax: 409-379-2698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. GLORIA D JONES
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 409-379-2647