Provider Demographics
NPI:1144216391
Name:MIDWIFERY ASSOCIATES
Entity Type:Organization
Organization Name:MIDWIFERY ASSOCIATES
Other - Org Name:FAMILY CENTERED MATERNITY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:972-278-2229
Mailing Address - Street 1:PO BOX 460988
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75046
Mailing Address - Country:US
Mailing Address - Phone:972-278-2229
Mailing Address - Fax:972-278-9065
Practice Address - Street 1:333 EAST CENTERVILLE RD.
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041
Practice Address - Country:US
Practice Address - Phone:972-278-2229
Practice Address - Fax:972-278-9065
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWIFERY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-23
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QB0400X
TX008501261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088337302Medicaid