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NPI Code Detail

MEDICARE: HEART OF TEXAS REGION MHMR

MEDICARE: HEART OF TEXAS REGION MHMR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336S0011XSpecialty Pharmacy15399TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14510055OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1558382515
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEART OF TEXAS REGION MHMR
Provider Business Mailing Address
First Line : PO BOX 890
Second Line :
City : WACO
State : TX
Zip : 76703-0890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 S 12TH ST
Second Line :
City : WACO
State : TX
Zip : 76701-1810
Country : US
Telephone Number : 254-752-3451
Fax Number : 254-755-6554
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. DANIEL THOMPSON
Credential :
Telephone Number : 254-752-3451
Provider Enumeration Date : 07/22/2006
Last Update Date : 03/05/2020

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Directions to “HEART OF TEXAS REGION MHMR ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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