Healthcare Provider Details

I. General information

NPI: 1508886417
Provider Name (Legal Business Name): CITY OF WHITEWRIGHT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 04/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 WEST GRAND ST
WHITEWRIGHT TX
75491
US

IV. Provider business mailing address

PO BOX 516
WHITEWRIGHT TX
75491-0516
US

V. Phone/Fax

Practice location:
  • Phone: 903-364-2211
  • Fax:
Mailing address:
  • Phone: 903-364-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number91010
License Number StateTX

VIII. Authorized Official

Name: BILL GOODSON
Title or Position: MAYOR
Credential:
Phone: 903-364-2211