Basic Information
| Provider Information | |||||||||
| NPI: | 1376709238 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTH PLAINS COMMUNITY ACTION ASSOCIATION, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 AUSTIN ST | ||||||||
| Address2: | |||||||||
| City: | LEVELLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 793364733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8068946104 | ||||||||
| FaxNumber: | 8068970835 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 AUSTIN ST | ||||||||
| Address2: | |||||||||
| City: | LEVELLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 793364733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8068946104 | ||||||||
| FaxNumber: | 8068970835 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2008 | ||||||||
| LastUpdateDate: | 07/31/2008 | ||||||||
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| AuthorizedOfficialLastName: | POWELL | ||||||||
| AuthorizedOfficialFirstName: | BIILL | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8068946104 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA0005X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Family Planning Facility |
ID Information
| ID | Type | State | Issuer | Description | 112045302 | 01 | TX | TEXAS TPI NUMBER | OTHER |