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General NPI Number Information
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NPI Number | 1083613640
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Entity Type | Organization
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Legal Business Name | REGENCE HEALTH NETWORK INC
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 410 CANYON ST
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City | PLAINVIEW
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State | TX
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Zip | 79072-7508
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Country | US
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Telephone | 806-293-8561
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Fax |
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Provider Business Mailing Address
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Address Line | 2801 W 8TH ST
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City | PLAINVIEW
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State | TX
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Zip | 79072-6737
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Country | US
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Telephone | 806-293-8561
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Fax | 806-293-8413
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Authorized Official
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Title or Position | CEO
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Name | RICK C LOVE
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Credential |
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Telephone | 806-293-8561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 321756-01
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License Number State | TX
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