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Organization
WILLIAM NISIMBLAT MDPA
Active
Organization
WILLIAM NISIMBLAT MDPA
Active
Other names
Alice Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM NISIMBLAT MD (OWNER)
(361) 664-5291
Entity
Organization
Contact information
Practice address
305 E THIRD ST, ALICE, TX 78332-4705
(361) 664-5291
(361) 668-1630
Mailing address
PO BOX 289, ALICE, TX 78333-4705
(361) 664-9353
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119654501
—
TX
05
—
119654502
—
TX
Enumeration date
10/02/2006
Last updated
02/09/2011
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