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General NPI Number Information
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NPI Number | 1841254174
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Entity Type | Organization
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Legal Business Name | DEWITT MEDICAL DISTRICT
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 3130 S BRAHMA BLVD
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City | KINGSVILLE
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State | TX
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Zip | 78363-7257
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Country | US
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Telephone | 361-592-8700
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Fax | 361-592-3030
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Provider Business Mailing Address
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Address Line | 2550 N ESPLANADE ST
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City | CUERO
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State | TX
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Zip | 77954-4736
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Country | US
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Telephone | 361-275-6191
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Fax | 361-275-3999
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Authorized Official
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Title or Position | CRO
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Name | ALMA ALEXANDER
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Credential |
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Telephone | 361-275-6191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 115826
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 675815
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License Number State | TX
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