=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356399059
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELL COUNTY PUBLIC HEALTH DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2006
-----------------------------------------------------
Last Update Date | 03/21/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 509 S 9TH ST
-----------------------------------------------------
City | TEMPLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76504-5567
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-778-4766
-----------------------------------------------------
Fax | 254-778-2912
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 509 S 9TH ST
-----------------------------------------------------
City | TEMPLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76504-5567
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-778-4766
-----------------------------------------------------
Fax | 254-778-2912
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF NURSES
-----------------------------------------------------
Name | MRS. CONSUELA MOLINA ELLIOTT
-----------------------------------------------------
Credential | W.H.N.P.-B.C.
-----------------------------------------------------
Telephone | 254-778-4766
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP0905X
-----------------------------------------------------
Taxonomy Name | State or Local Public Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------