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General NPI Number Information
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NPI Number | 1992473391
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Entity Type | Organization
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Legal Business Name | TEXAS HEALTH FOUNDATION, INC
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 3610 STAGG DR
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City | BEAUMONT
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State | TX
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Zip | 77701-3713
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Country | US
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Telephone | 409-923-0012
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7072
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City | BEAUMONT
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State | TX
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Zip | 77726-7072
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Country | US
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Telephone | 409-923-0012
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY A WILSON
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Credential |
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Telephone | 409-923-0012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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