1306332176 NPI number — CENTEX CHILDCARE, INC.

Table of content: (NPI 1306332176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306332176 NPI number — CENTEX CHILDCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTEX CHILDCARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WILLIAMS HOUSE EMERGENCY CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306332176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 487
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GOLDTHWAITE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76844-0487
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-648-3131
Provider Business Mailing Address Fax Number:
325-648-3931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOMETA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76853-2104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-752-3952
Provider Business Practice Location Address Fax Number:
512-752-3883
Provider Enumeration Date:
07/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
VERNON
Authorized Official Title or Position:
MC-ARMS
Authorized Official Telephone Number:
325-648-3131

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  15615 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X , with the licence number: 827818 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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