Organization
NEWTON FAMILY CLINIC, PA
Active
Organization
NEWTON FAMILY CLINIC, PA
Active
Parent organization
NEWTON FAMILY CLINIC, PA
Other names
Newton Family Rural Health Clinic @ Jasper
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEWTON FAMILY CLINIC, PA
Authorized official
BRAD THIBODAUX (CHIEF DATA OFFICER)
(409) 384-8990
Entity
Organization
Contact information
Practice address
561 STATE STREET, JASPER, TX 75951-5134
(409) 384-8990
(409) 384-9921
Mailing address
561 STATE ST, JASPER, TX 75951-5134
(409) 384-8990
(409) 384-9921
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
G3189
TX
261QR1300X
Rural Health Clinic/Center
Primary
G3189
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
571660
NURSES LICENCES
TX
01
—
742386
NURSES LICENSE
TX
01
—
PA02232
PA LICENCE
TX
Enumeration date
08/15/2007
Last updated
01/28/2014
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