DEWITT MEDICAL DISTRICT (NPI# 1659770030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659770030 |
| Entity Type | Organization |
| Organization Name | DEWITT MEDICAL DISTRICT |
| Other Organization Name | PARKSIDE FAMILY CLINIC |
| Practice Address |
1109 E Broadway St Cuero TX 77954-2108 |
| Practice Telephone | 3612752800 |
| Practice Fax Number | 3612758791 |
| Mailing Telephone | 3612752800 |
| Mailing Fax Number | 3612758791 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2016-06-30 |
| Authorized Official Name | LYNN FALCONE (ADMINISTRATOR/CEO) |
| Authorized Official Telephone | 3612756191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 344242801 | 05 | |
| TX | 350897002 | 05 | |
| TX | 350897001 | 05 |
| Other Name | Type Code |
|---|---|
| Parkside Family Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811357155 | Dewitt Medical District | Skilled Nursing Facility | 222 Bertetti Dr, San Antonio, TX 78227-3950 | 2016-02-29 |
| 1932596343 | Dewitt Medical District | Nursing Facility/Intermediate Care Facility | 4162 Wildcat Dr, Corpus Christi, TX 78410-5100 | 2015-04-23 |
| 1396144770 | Dewitt Medical District | Skilled Nursing Facility | 710 Highway 359 S, Brookshire, TX 77423 | 2014-08-21 |
| 1851629430 | Dewitt Medical District | Durable Medical Equipment & Medical Supplies | 5301 W Duval Rd, Austin, TX 78727-6618 | 2009-11-19 |
| 1396789491 | Dewitt Medical District | Skilled Nursing Facility | 208 Maple Street, Luling, TX 78648 | 2006-06-16 |
| 1861442469 | Dewitt Medical District | Nursing Facility/Intermediate Care Facility | 2735 Airline Road, Corpus Christi, TX 78414 | 2006-05-12 |
| 1841254174 | Dewitt Medical District | Nursing Facility/Intermediate Care Facility | 3130 S Brahma Blvd, Kingsville, TX 78363-7257 | 2006-04-13 |
| 1558331421 | Dewitt Medical District | Home Health | 615 N Esplanade St, Cuero, TX 77954 | 2006-01-24 |
| 1235671629 | Dewitt Medical District | Skilled Nursing Facility | 2 Towers Park Ln, San Antonio, TX 78209-6410 | 2016-11-16 |
| 1396296521 | Dewitt Medical District | Durable Medical Equipment & Medical Supplies | 2550 N Esplanade St, Cuero, TX 77954-4736 | 2016-10-24 |
| Street Address |
1109 E BROADWAY ST |
| City | CUERO |
| State | TX |
| Zip Code | 77954-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689645376 | Parkside Family Clinic, Pa | Family Medicine | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-01-30 |
| 1285164749 | Hermelinda Fitts | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2017-06-18 |
| 1487009734 | Cody A Walthall | Family Medicine | 1109 E Broadway St, Cuero, TX 77954 | 2016-04-24 |
| 1063793123 | Summer Laake | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2011-09-02 |
| 1962528778 | Kelly M Sullivan | Social Worker | 1109 E Broadway St, Cuero, TX 77954-2108 | 2007-03-22 |
| 1922196393 | Troy W Lischka | Physician Assistant | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-10-11 |
| 1861595936 | Judith Ann Krupala | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-09-06 |
| 1700893484 | Herbert J Hall | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649658279 | H-e-b, Lp | Clinical Medical Laboratory | 909 E Broadway St, Cuero, TX 77954 | 2015-05-15 |
| 1558331421 | Dewitt Medical District | Home Health | 615 N Esplanade St, Cuero, TX 77954 | 2006-01-24 |
| 1922367366 | D Ross Braune Ma Lpc and Associates | Counselor | 401 Broadway Ave., 100, Cuero, TX 77954 | 2012-05-04 |
| 1053487868 | Dewitt Medical District | Nursing Care | 615 N Esplanade St, Cuero, TX 77954 | 2006-11-27 |
| 1770699027 | Cuero Medical Associates Pa | Family Medicine | 2500 N Esplanade, Suite 102, Cuero, TX 77954 | 2006-08-21 |
| 1710202098 | David Ronald Polasek | Pharmacist | 515 N Esplanade, Cuero, TX 77954-0270 | 2010-03-30 |
| 1124284500 | Renal Treatment Centers Southeast Lp | Clinic/Center | 1105 E Broadway St, Cuero, TX 77954-2108 | 2008-08-05 |
| 1104843382 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 1202 E Broadway St, Cuero, TX 77954-2124 | 2006-07-16 |
| 1376082396 | Kevin Ferrall | Pharmacist | 909 E Broadway St, Cuero, TX 77954-2126 | 2017-02-23 |
| 1104953215 | Dewitt-lavaca Special Education Cooperative | Counselor | 960 E Broadway St, Cuero, TX 77954-2131 | 2007-02-27 |
| Find all providers in zip 77954 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053405167 | Cuero Medical Associates, P.a. | Clinic/Center | 2500 N Esplanade St, Suite 102, Cuero, TX 77954-4723 | 2006-10-03 |
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| 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.