Provider Demographics
NPI:1427015163
Name:CITY OF ABILENE
Entity Type:Organization
Organization Name:CITY OF ABILENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LERMA
Authorized Official - Suffix:
Authorized Official - Credentials:CPH
Authorized Official - Phone:325-437-4671
Mailing Address - Street 1:850 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-5242
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:850 N 6TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5242
Practice Address - Country:US
Practice Address - Phone:325-692-5600
Practice Address - Fax:325-734-5370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7214251K00000X, 261QA0005X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148090701Medicaid
TX35012801Medicaid
TX35012802Medicaid
TX091779102Medicaid
TX360804401Medicaid
TX018967201Medicaid
TX35012802Medicaid