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General NPI Number Information
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NPI Number | 1871525683
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Entity Type | Organization
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Legal Business Name | CITY OF WACO
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 225 WEST WACO DRIVE
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City | WACO
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State | TX
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Zip | 76707-3897
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Country | US
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Telephone | 254-750-5409
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Fax | 254-750-5455
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Provider Business Mailing Address
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Address Line | 225 WEST WACO DRIVE
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City | WACO
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State | TX
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Zip | 76707-3897
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Country | US
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Telephone | 254-750-5409
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Fax | 254-750-5455
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Authorized Official
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Title or Position | DIRECTOR
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Name | SHERRY L. WILLIAMS
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Credential |
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Telephone | 254-750-5459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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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 | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number | F7262
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License Number State | TX
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