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General NPI Number Information
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NPI Number | 1053487868
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Entity Type | Organization
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Legal Business Name | DEWITT MEDICAL DISTRICT
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 615 N ESPLANADE ST
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City | CUERO
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State | TX
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Zip | 77954
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Country | US
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Telephone | 361-275-8999
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Fax | 361-275-8970
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Provider Business Mailing Address
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Address Line | 615 N ESPLANADE ST
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City | CUERO
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State | TX
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Zip | 77954-3605
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Country | US
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Telephone | 361-275-8999
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Fax | 361-275-8970
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Authorized Official
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Title or Position | HOME CARE ADMINISTRATOR
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Name | MRS. MARGARET KRAUSE
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Credential | RN
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Telephone | 361-275-8999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1140
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License Number State | TX
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