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General NPI Number Information
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NPI Number | 1366167199
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Entity Type | Organization
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Legal Business Name | CHECKPOINT HEALTH TEXAS PLLC
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 3411 HAWTHORNE RD
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City | POCATELLO
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State | ID
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Zip | 83201-6061
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Country | US
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Telephone | 888-539-2115
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Fax | 888-539-2115
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Provider Business Mailing Address
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Address Line | 3411 HAWTHORNE RD
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City | POCATELLO
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State | ID
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Zip | 83201-6061
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Country | US
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Telephone | 888-539-2115
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Fax | 888-539-2115
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RONALD O BROWNE
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Credential | MD
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Telephone | 760-440-5220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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