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General NPI Number Information
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NPI Number | 1689898249
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Entity Type | Organization
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Legal Business Name | COMMUNITY MOTHER AND CHILD HEALTH CENTER
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 510 E RIO GRANDE ST
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City | VICTORIA
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State | TX
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Zip | 77901-6033
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Country | US
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Telephone | 361-570-1082
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Fax |
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Provider Business Mailing Address
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Address Line | 510 E RIO GRANDE ST
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City | VICTORIA
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State | TX
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Zip | 77901-6033
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Country | US
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Telephone | 361-570-1082
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Fax |
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Authorized Official
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Title or Position | WHCNP
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Name | MS. ANGELA DAWN WILLIAMS
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Credential | R.N., WHCNP
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Telephone | 361-570-1082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 595240
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License Number State | TX
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