Provider Demographics
NPI:1205260585
Name:DEWITT MEDICAL DISTRICT
Entity type:Organization
Organization Name:DEWITT MEDICAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRITCHETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-275-6191
Mailing Address - Street 1:2550 N ESPLANADE ST
Mailing Address - Street 2:
Mailing Address - City:CUERO
Mailing Address - State:TX
Mailing Address - Zip Code:77954-4736
Mailing Address - Country:US
Mailing Address - Phone:361-275-6191
Mailing Address - Fax:361-275-3999
Practice Address - Street 1:200 E 2ND ST
Practice Address - Street 2:
Practice Address - City:NIXON
Practice Address - State:TX
Practice Address - Zip Code:78140-2737
Practice Address - Country:US
Practice Address - Phone:830-582-1222
Practice Address - Fax:830-582-2032
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEWITT MEDICAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-22
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty