Provider Demographics
NPI:1164903092
Name:CACTUS NAZARENE HEALTH CENTER
Entity Type:Organization
Organization Name:CACTUS NAZARENE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:NORISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-206-1494
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:CACTUS
Mailing Address - State:TX
Mailing Address - Zip Code:79013-0387
Mailing Address - Country:US
Mailing Address - Phone:806-934-5755
Mailing Address - Fax:806-421-2611
Practice Address - Street 1:200 PALO DURO
Practice Address - Street 2:
Practice Address - City:CACTUS
Practice Address - State:TX
Practice Address - Zip Code:79013-0990
Practice Address - Country:US
Practice Address - Phone:806-934-5755
Practice Address - Fax:806-421-2611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care