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General NPI Number Information
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NPI Number | 1740629492
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Entity Type | Organization
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Legal Business Name | SCOTT AND WHITE HEALTHCARE
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 302 UNIVERSITY BLVD
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City | ROUND ROCK
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State | TX
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Zip | 78665-1032
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Country | US
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Telephone | 512-509-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 1745 WESTEND PL
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City | ROUND ROCK
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State | TX
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Zip | 78681-2252
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Country | US
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Telephone | 512-818-2953
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Fax |
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Authorized Official
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Title or Position | SYSTEM ENROLLMENT SPECIALIST
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Name | ANNIE HUGHES
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Credential |
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Telephone | 254-215-9790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 9
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License Number State | TX
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