Provider Demographics
NPI:1619115334
Name:AGGIELAND PREGNANCY OUTREACH, INC.
Entity Type:Organization
Organization Name:AGGIELAND PREGNANCY OUTREACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:CAMILLE
Authorized Official - Last Name:SCHAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:979-764-6636
Mailing Address - Street 1:2501 TEXAS AVE S
Mailing Address - Street 2:SUITE C-105
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-5079
Mailing Address - Country:US
Mailing Address - Phone:979-764-6636
Mailing Address - Fax:979-764-6186
Practice Address - Street 1:2501 TEXAS AVE S
Practice Address - Street 2:SUITE C-105
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-5079
Practice Address - Country:US
Practice Address - Phone:979-764-6636
Practice Address - Fax:979-764-6186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX819927251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management