MEDMARK TREATMENT CENTERS OF TEXAS INC NPI 1083931562

NPI Information

NPI: 1083931562
Provider Name: MEDMARK TREATMENT CENTERS OF TEXAS, INC

Doing Business As: MEDMARK TREATMENT CENTERS WACO

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 45D2026181

Address:
2210 WASHINGTON AVE
WACO, TX
ZIP 76701
Phone: (254) 755-6411
Get Directions

MEDMARK TREATMENT CENTERS OF TEXAS, INC is a rehabilitation and substance use disorder clinic center in Waco, TX. MEDMARK TREATMENT CENTERS OF TEXAS, INC NPI is 1083931562. The provider is registered as an organization entity type.
The provider Is Doing Business As Medmark Treatment Centers Waco.

The provider's business location address is:

2210 WASHINGTON AVE
WACO, TX
ZIP 76701-019
Phone: (254) 755-6411
Fax: (254) 755-6422

The provider's authorized official is Michael Saul .
The authorized official title is Vp and has the following contact phone number (214) 379-3300.

The CLIA number assigned to this NPI record is 45D2026181 - other - narcotic trtmt prgm with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/23/2010 and was last updated on 2/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2800X	Clinic/Center	Methadone	0000058	TEXAS	No
2	261QM2800X	Clinic/Center	Methadone	1000028	TEXAS	No
3	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	1000028	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1000028	OTHER	TEXAS	ST LICENSE
2	285947201	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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