1861763906 NPI number — HALE COUNTY MEALS ON WHEELS

Table of content: DR. ROBERT ALEXANDER DE LA TORRE MD (NPI 1043079445)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861763906 NPI number — HALE COUNTY MEALS ON WHEELS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HALE COUNTY MEALS ON WHEELS
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:
Provider Other Organization Name Type Code:
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:
1861763906
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 MESA CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLAINVIEW
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79072-6507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-292-9020
Provider Business Mailing Address Fax Number:
806-293-0037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2601 DIMMITT RD
Provider Second Line Business Practice Location Address:
COVENANT HOSPITAL PLAINVIEW
Provider Business Practice Location Address City Name:
PLAINVIEW
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79072-1833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-292-9020
Provider Business Practice Location Address Fax Number:
806-293-0037
Provider Enumeration Date:
01/20/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HORNE
Authorized Official First Name:
KIM
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
806-292-9020

Provider Taxonomy Codes

  • Taxonomy code: 332U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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