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General NPI Number Information
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NPI Number | 1245765163
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Entity Type | Organization
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Legal Business Name | HHSC WIC PROGRAM
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 4616 W HOWARD LN STE 840
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City | AUSTIN
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State | TX
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Zip | 78728-6300
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Country | US
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Telephone | 512-341-4598
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Fax |
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Provider Business Mailing Address
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Address Line | TEXAS HEALTH AND HUMAN SERVICES COMMISION PO BOX 149099 ARTS BILLING MC1470
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City | AUSTIN
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State | TX
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Zip | 78714
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | WIC DIRECTOR
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Name | MR. EDGAR CURTIS
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Credential |
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Telephone | 512-341-4563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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