Basic Information
| Provider Information | |||||||||
| NPI: | 1417328279 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SOUTH PLAINS RURAL HEALTH SERVICES, INC. | ||||||||
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| OtherOrganizationName: | HOWARD COUNTY COMMUNITY HEALTH CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 FM 300 | ||||||||
| Address2: | |||||||||
| City: | LEVELLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 793366235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8068947842 | ||||||||
| FaxNumber: | 8068943378 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 S GREGG STREET | ||||||||
| Address2: | |||||||||
| City: | LAMESA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4325174557 | ||||||||
| FaxNumber: | 4325174561 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2015 | ||||||||
| LastUpdateDate: | 10/19/2015 | ||||||||
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| AuthorizedOfficialLastName: | HASKELL | ||||||||
| AuthorizedOfficialFirstName: | TARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8068947842 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 537334 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | General Practice |
No ID Information.