Provider Demographics
NPI:1528229192
Name:VCPHCS III, LP
Entity Type:Organization
Organization Name:VCPHCS III, LP
Other - Org Name:TEXOMA TREATMENT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:DRAUDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-346-3821
Mailing Address - Street 1:5950 SHERRY LN
Mailing Address - Street 2:SUITE 750
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6533
Mailing Address - Country:US
Mailing Address - Phone:214-346-3821
Mailing Address - Fax:214-346-3808
Practice Address - Street 1:1615 KEMP BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-2265
Practice Address - Country:US
Practice Address - Phone:940-322-3955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEHAVIORAL HEALTH GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX10218M101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty