Organization
SPECIAL HEALTH RESOURCES FOR TEXAS INCORPORATED
Active
Other names
INTEGRATED PEDIATRIC CARE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
KIM DALE NESVIG (CEO)
(903) 234-0776
Entity
Organization
Contact information
Practice address
1911 GALLERIA OAKS DR, TEXARKANA, TX 75503-4617
(903) 792-0308
(903) 792-0007
Mailing address
PO BOX 2709, LONGVIEW, TX 75606-2709
(903) 234-0776
(903) 234-9769
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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