MEDMARK TREATMENT CENTERS OF TEXAS INC (NPI# 1083931562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083931562 |
| Entity Type | Organization |
| Organization Name | MEDMARK TREATMENT CENTERS OF TEXAS INC |
| Practice Address |
2210 Washington Ave Waco TX 76701-1019 |
| Mailing Address |
1720 Lakepointe Dr Ste 117 Lewisville TX 75057-6425 |
| Practice Telephone | 2547556411 |
| Practice Fax Number | 2547556422 |
| Mailing Telephone | 2143793300 |
| Mailing Fax Number | 2148539018 |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2020-07-15 |
| Authorized Official Name | BOND ANDREWS (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Telephone | 2143793398 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
0000058 | TX | Ambulatory Health Care Facilities |
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
1000028 | TX | Ambulatory Health Care Facilities |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1000028 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | ST LICENSE | 1000028 | 01 |
| TX | 285947201 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770781106 | Medmark Treatment Centers of Texas Inc | Clinic/Center | 5201 Mccart Ave, Suite H, Fort Worth, TX 76115-3711 | 2007-07-06 |
| Street Address |
2210 WASHINGTON AVE |
| City | WACO |
| State | TX |
| Zip Code | 76701-1019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780005744 | Cenikor Foundation | Counselor | 900 Austin Avenue, Suite 1103, Waco, TX 76701 | 2013-12-18 |
| 1730412073 | Lauren Corinne Smith | Occupational Therapist | 900 Washington Avenue, Waco, TX 76701 | 2009-09-17 |
| 1750554093 | Juanita Castillo | Internal Medicine | 1226 Washington Avenue, Waco, TX 76701 | 2008-04-08 |
| 1306958426 | Daniel Ray Davis | Dentist | 2305 Austin, Waco, TX 76701 | 2006-08-31 |
| 1003886003 | Elite Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 2105 Franklin Ave, Waco, TX 76701 | 2006-01-24 |
| 1740680750 | Kayleigh Anderson | Counselor | 110 S 12th St, Waco, TX 76701 | 2014-08-27 |
| 1477821593 | Michelle Elizabeth Girard | Speech-Language Pathologist | 900 Washington Ave, Waco, TX 76701 | 2011-12-03 |
| 1871781302 | Robert Craig Rainey | Family Medicine | 1226 Washington Ave, Waco, TX 76701 | 2007-10-10 |
| 1407972581 | Sarah S. Allen | Marriage & Family Therapist | 110 S 12th St, Waco, TX 76701 | 2007-03-21 |
| 1730478777 | Garret Pool | Family Medicine | 600 Franklin Ave, Suite B-c, Waco, TX 76701-0002 | 2011-03-30 |
| Find all providers in zip 76701 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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|---|---|---|---|---|
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| 1861860892 | Heart of Texas Region Mental Health Mental Retardation Center | Clinic/Center | 1105 Jefferson Ave, Waco, TX 76701-1212 | 2015-09-08 |
| 1174860266 | Henry David Hardt Ph D | Clinic/Center | 4555 Lake Shore Dr, Waco, TX 76710-1814 | 2013-01-09 |
| 1497011456 | Lake Shore Center for Behavioral Health, LLC | Clinic/Center | 4555 Lake Shore Dr, Waco, TX 76710-1814 | 2012-04-04 |
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| 1154953917 | Finch Clinic, Pllc. | Clinic/Center | 1105 Memorial Dr Ste 102, Denison, TX 75020-2043 | 2020-02-10 |
| 1265063689 | Cenikorfoundation | Clinic/Center | 5501 Interstate Hwy 37, Corpus Christi, TX 78408 | 2020-02-04 |
| 1598306862 | Ethos Wellness-the Prairie Recovery Center | Clinic/Center | 5808 Wagner Rd, Round Top, TX 78954-5075 | 2019-10-08 |
| 1619539509 | Arc Counseling LLC | Clinic/Center | 5700 Nw Central Dr Ste 130, Houston, TX 77092-2000 | 2019-07-01 |
| 1982261988 | Davecolephd and Associates | Clinic/Center | 4702 Old Spanish Trl Ste 106, Houston, TX 77021-1718 | 2019-05-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.