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General NPI Number Information
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NPI Number | 1780044545
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Entity Type | Organization
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Legal Business Name | FCI BIG SPRING
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 1900 SIMLER AVE
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City | BIG SPRING
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State | TX
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Zip | 79720-7789
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Country | US
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Telephone | 432-466-2438
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 SIMLER AVE
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City | BIG SPRING
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State | TX
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Zip | 79720-7789
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Country | US
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Telephone | 432-466-2438
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Fax |
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Authorized Official
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Title or Position | HEALTH SERVICES ADMINISTRATOR
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Name | TELEISA CRNKOVICH
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Credential | HSA
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Telephone | 432-466-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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