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General NPI Number Information
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NPI Number | 1851629430
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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 | 11/19/2009
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 5301 W DUVAL RD
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City | AUSTIN
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State | TX
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Zip | 78727-6618
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Country | US
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Telephone | 512-345-1805
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Fax | 512-349-9146
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Provider Business Mailing Address
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Address Line | 5301 DUVAL RD
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City | AUSTIN
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State | TX
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Zip | 78727-6618
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Country | US
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Telephone | 512-345-1805
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Fax | 512-349-9146
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Authorized Official
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Title or Position | CFO
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Name | MR. GREG PRITCHETT
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Credential |
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Telephone | 361-275-0504
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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 |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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