Organization
HEART OF TEXAS REGION MHMR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL THOMPSON (EXECUTIVE DIRECTOR)
(254) 752-3451
Entity
Organization
Contact information
Practice address
110 S 12TH ST, WACO, TX 76701-1810
(254) 752-3451
(254) 755-6554
Mailing address
PO BOX 890, WACO, TX 76703-0890
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
15399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4510055
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/22/2006
Last updated
03/05/2020
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