Organization
DEWITT MEDICAL DISTRICT
Active
Other names
GOLIAD FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
ALMA ALEXANDER (CFO)
(361) 275-6191
Entity
Organization
Contact information
Practice address
139 W FRANKLIN ST, GOLIAD, TX 77963-4281
(361) 645-8235
(361) 645-3282
Mailing address
139 W FRANKLIN ST, GOLIAD, TX 77963-4281
(361) 645-8235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
357774401
—
TX
01
—
363141801
MEDICAID RHC
TX
01
—
363141802
THSTEPS RHC MEDICAID
TX
Enumeration date
09/03/2015
Last updated
08/18/2022
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