Provider Demographics
NPI:1104959790
Name:PLANNED PARENTHOOD OF GREATER TEXAS FAMILY PLANNING & PREVENTATIVE HEA
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF GREATER TEXAS FAMILY PLANNING & PREVENTATIVE HEA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:V.P. HEALTH SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-363-2004
Mailing Address - Street 1:700 W. HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 W HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712
Practice Address - Country:US
Practice Address - Phone:254-759-5762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176952301OtherMEDICAID PRENATAL
TX112269901Medicare ID - Type Unspecified
TX176952301OtherMEDICAID PRENATAL