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General NPI Number Information
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NPI Number | 1245224799
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Entity Type | Organization
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Legal Business Name | JIM RIGGINS
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 JANE LN
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City | HILLSBORO
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State | TX
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Zip | 76645-2673
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Country | US
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Telephone | 254-582-5363
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Fax | 254-582-7429
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Provider Business Mailing Address
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Address Line | 101 JANE LN
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City | HILLSBORO
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State | TX
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Zip | 76645-2673
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Country | US
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Telephone | 254-582-5363
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Fax | 254-582-7429
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Authorized Official
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Title or Position | OWNER
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Name | MISS JIM RIGGINS
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Credential | R.PH.
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Telephone | 254-582-5363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 00218
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License Number State | TX
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