Provider Demographics
NPI:1144928813
Name:JIM NED PREMIER HEALTH & MED SPA, PLLC
Entity type:Organization
Organization Name:JIM NED PREMIER HEALTH & MED SPA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-554-7072
Mailing Address - Street 1:731 GRAHAM ST.
Mailing Address - Street 2:
Mailing Address - City:TUSCOLA
Mailing Address - State:TX
Mailing Address - Zip Code:79562-3724
Mailing Address - Country:US
Mailing Address - Phone:325-554-7072
Mailing Address - Fax:325-554-7073
Practice Address - Street 1:731 GRAHAM ST.
Practice Address - Street 2:
Practice Address - City:TUSCOLA
Practice Address - State:TX
Practice Address - Zip Code:79562-7956
Practice Address - Country:US
Practice Address - Phone:432-557-6694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care