| NAME |
CHILDRESS VA CLINIC |
| STATE |
TEXAS |
| STREET ADDR. 1 |
2305 AVENUE F NW STE 900 |
| CITY |
CHILDRESS |
| ZIP |
79201-2113 |
| OFFICIAL VA NAME |
CHILDRESS VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CHILDRESS VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1629022520
-
- 2022-01-05 00:00:00
- STATUS: ACTIVE
- NPI: 1629022520
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
504GA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 803 US HIGHWAY 83 N
- CITY (CHANGED FROM): CHILDRESS
- STATE (CHANGED FROM): TEXAS
- ZIP (CHANGED FROM): 79201-2318
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1629022520
-
- CODING SYSTEM: VASTANUM
- ID: 504GA
|
