| NAME |
PALESTINE VA CLINIC |
| STATE |
TEXAS |
| STREET ADDR. 1 |
300 WILLOW CREEK PKWY STE 100 |
| CITY |
PALESTINE |
| ZIP |
75801-4433 |
| OFFICIAL VA NAME |
PALESTINE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PALESTINE VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1184662736
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
674GA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 2000 SO. LOOP 256, SUITE 124
- CITY (CHANGED FROM): PALESTINE
- STATE (CHANGED FROM): TEXAS
- ZIP (CHANGED FROM): 75801-5932
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1184662736
-
- CODING SYSTEM: VASTANUM
- ID: 674GA
-
- CODING SYSTEM: CLIA
- ID: 45D1006105
|
