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Organization
JOS INC ROUTH STREET WOMENS CLINIC
Active
Organization
JOS INC ROUTH STREET WOMENS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGINIA BRAUN (CO-OWNER)
(214) 748-8611
Entity
Organization
Contact information
Practice address
4321 N CENTRAL EXPY, DALLAS, TX 75205-4524
(214) 748-8611
Mailing address
4321 N CENTRAL EXPY, DALLAS, TX 75205-4524
(214) 748-8611
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
007278
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
874150
BLUE CROSS
TX
Enumeration date
01/12/2008
Last updated
06/18/2008
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