Provider Demographics
NPI:1376719211
Name:CHILDBIRTH SERVICES
Entity Type:Organization
Organization Name:CHILDBIRTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-769-3520
Mailing Address - Street 1:200 E HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-8131
Mailing Address - Country:US
Mailing Address - Phone:903-592-2406
Mailing Address - Fax:903-592-2225
Practice Address - Street 1:200 E HOUSTON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-8131
Practice Address - Country:US
Practice Address - Phone:903-592-2406
Practice Address - Fax:903-592-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007806261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing