Organization
SCOTT & WHITE CLINIC
Active
Other names
Scott & White Infusion Center
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE CANTU (ASSOC VICE PRESIDENT, RCO)
(254) 215-9719
Entity
Organization
Contact information
Practice address
1600 UNIVERSITY DR E, COLLEGE STATION, TX 77840-2642
(409) 691-3300
Mailing address
PO BOX 847408, DALLAS, TX 75284-7408
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00DG13
BLUE SHIELD
TX
05
—
1600678-01
—
TX
05
—
1600678-02
—
TX
01
—
4356110002
RR/MEDICARE
TX
Enumeration date
04/12/2006
Last updated
12/27/2012
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