Provider Demographics
NPI:1861755860
Name:MEXIA PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:MEXIA PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-8500
Mailing Address - Street 1:701 NE 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:TX
Mailing Address - Zip Code:76648-2203
Mailing Address - Country:US
Mailing Address - Phone:254-576-1138
Mailing Address - Fax:254-576-1142
Practice Address - Street 1:701 NE 5TH ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:TX
Practice Address - Zip Code:76648-2203
Practice Address - Country:US
Practice Address - Phone:254-576-1138
Practice Address - Fax:254-576-1142
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEXIA PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health