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Organization
HAYS CISD WELL CLINIC
Active
Organization
HAYS CISD WELL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH ROBERTS RN, MSN (DIRECTOR)
(512) 268-8474
Entity
Organization
Contact information
Practice address
3839 E FM 150, KYLE, TX 78640-6072
(512) 268-5218
(512) 268-5219
Mailing address
21003 IH 35, KYLE, TX 78640-4745
(512) 268-5218
(512) 268-5219
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
TX
363LP0200X
Pediatric Nurse Practitioner
587900
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182837801
—
TX
05
—
182837802
—
TX
05
—
182837803
—
TX
Enumeration date
04/24/2007
Last updated
04/20/2011
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