Organization
MEDMARK TREATMENT CENTERS OF TEXAS, INC.
Active
Other names
MedMark Treatment Centers Waco
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE JARVIE (VP, TREASURER)
(214) 379-3300
Entity
Organization
Contact information
Practice address
2210 WASHINGTON AVE, WACO, TX 76701-1019
(254) 755-6411
(254) 755-6422
Mailing address
1720 LAKEPOINTE DR STE 117, LEWISVILLE, TX 75057-6425
(214) 379-3300
(214) 853-9018
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
0000058
TX
261QM2800X
Methadone Clinic
1000028
TX
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1000028
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000028
ST LICENSE
TX
05
—
285947201
—
TX
Enumeration date
04/23/2010
Last updated
07/29/2024
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