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General NPI Number Information
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NPI Number | 1346281573
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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 | 06/09/2006
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 611 N BROAD ST
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City | LAMPASAS
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State | TX
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Zip | 76550-1105
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Country | US
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Telephone | 512-556-3588
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Fax | 512-556-2507
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Provider Business Mailing Address
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Address Line | 611 N BROAD ST
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City | LAMPASAS
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State | TX
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Zip | 76550-1105
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Country | US
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Telephone | 512-556-3588
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Fax | 512-556-2507
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | ALMA ALEXANDER
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Credential |
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Telephone | 361-275-0504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 115094
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License Number State | TX
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