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General NPI Number Information
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NPI Number | 1285964205
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Entity Type | Organization
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Legal Business Name | PACHAMAMA BIRTH CENTER
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 700 PANORAMA DR
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-2515
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Country | US
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Telephone | 512-858-0415
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Fax | 888-863-8691
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Provider Business Mailing Address
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Address Line | 700 PANORAMA DR
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-2515
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Country | US
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Telephone | 512-858-0415
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Fax | 888-863-8691
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | MS. GURUBACHAN KHALSA
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Credential | LM, CPM
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Telephone | 512-858-0145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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