| NAME |
TEXARKANA |
| STATE |
TEXAS |
| STREET ADDR. 1 |
5701 SUMMERHILL RD |
| CITY |
TEXARKANA |
| ZIP |
75503-1634 |
| OFFICIAL VA NAME |
TEXARKANA CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
TEXARKANA VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1417996489
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
667GA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 910 REALTOR ROAD
- CITY (CHANGED FROM): TEXARKANA
- STATE (CHANGED FROM): ARKANSAS
- ZIP (CHANGED FROM): 71854-1020
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1417996489
-
- CODING SYSTEM: VASTANUM
- ID: 667GA
-
- CODING SYSTEM: CLIA
- ID: 45D1001738
|
