DEWITT MEDICAL DISTRICT NPI 1659770030

NPI Information

NPI: 1659770030
Provider Name: DEWITT MEDICAL DISTRICT

Doing Business As: PARKSIDE FAMILY CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1109 E BROADWAY ST
CUERO, TX
ZIP 77954
Phone: (361) 275-2800
Get Directions

DEWITT MEDICAL DISTRICT is a rural health clinic center in Cuero, TX. DEWITT MEDICAL DISTRICT NPI is 1659770030. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Parkside Family Clinic.

The provider's business location address is:

1109 E BROADWAY ST
CUERO, TX
ZIP 77954-108
Phone: (361) 275-2800
Fax: (361) 275-8791

The provider's authorized official is Lynn Falcone .
The authorized official title is Administrator/ceo and has the following contact phone number (361) 275-6191.

The CLIA number assigned to this NPI record is 45D0498841 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2014 and was last updated on 8/18/2022.

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	207Q00000X	Family Medicine				No
2	261QR1300X	Clinic/Center	Rural Health			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
1	344242801	MEDICAID	TEXAS
2	350897001	MEDICAID	TEXAS
3	350897002	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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