Provider Demographics
NPI:1164005559
Name:TEXANA CENTER
Entity Type:Organization
Organization Name:TEXANA CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALINGCONTRACTING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:E
Authorized Official - Last Name:HADAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-239-1445
Mailing Address - Street 1:4910 AIRPORT AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5759
Mailing Address - Country:US
Mailing Address - Phone:281-239-1445
Mailing Address - Fax:281-239-0828
Practice Address - Street 1:4910 AIRPORT AVE STE D
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5759
Practice Address - Country:US
Practice Address - Phone:281-239-1445
Practice Address - Fax:281-239-0828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXANA CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081522701Medicaid