Provider Demographics
NPI:1275565855
Name:ENDOCRINOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:ENDOCRINOLOGY ASSOCIATES
Other - Org Name:DIABETIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-677-5201
Mailing Address - Street 1:2125 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2435
Mailing Address - Country:US
Mailing Address - Phone:325-677-5201
Mailing Address - Fax:325-677-3531
Practice Address - Street 1:2125 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2435
Practice Address - Country:US
Practice Address - Phone:325-677-5201
Practice Address - Fax:325-677-3531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0914418-02Medicaid
TX0859250001Medicare NSC