=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033176391
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLIAMSON COUNTY & CITIES HEALTH DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2006
-----------------------------------------------------
Last Update Date | 05/09/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 W 6TH ST
-----------------------------------------------------
City | TAYLOR
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76574-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-238-2121
-----------------------------------------------------
Fax | 512-238-2179
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 W 3RD ST
-----------------------------------------------------
City | GEORGETOWN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78626-5030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-943-3600
-----------------------------------------------------
Fax | 512-943-1499
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | JAMES K MORGAN
-----------------------------------------------------
Credential | MD, MPH
-----------------------------------------------------
Telephone | 512-943-3600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------