Provider Demographics
NPI:1538343694
Name:CENTRAL TEXAS MHMR CENTER
Entity type:Organization
Organization Name:CENTRAL TEXAS MHMR CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DION
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-643-3363
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-0250
Mailing Address - Country:US
Mailing Address - Phone:325-646-9574
Mailing Address - Fax:325-646-1951
Practice Address - Street 1:408 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-1639
Practice Address - Country:US
Practice Address - Phone:325-646-9574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133339505OtherTMHP TPI