Provider Demographics
NPI:1649579533
Name:OWENS FRANKLIN HEALTH CENTER, PRAIRIE VIEW A&M UNIVERSITY
Entity Type:Organization
Organization Name:OWENS FRANKLIN HEALTH CENTER, PRAIRIE VIEW A&M UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-261-1410
Mailing Address - Street 1:PO BOX 2598
Mailing Address - Street 2:REDA BLAND EVANS @ O. J. BAKER STREET
Mailing Address - City:PRAIRIE VIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77446-2598
Mailing Address - Country:US
Mailing Address - Phone:936-261-1410
Mailing Address - Fax:936-857-4999
Practice Address - Street 1:OFHC, REDA BLAND EVANS @ O. J. BAKER STREET
Practice Address - Street 2:PRAIRIE VIEW A&M UNIVERSITY
Practice Address - City:PRAIRIE VIEW
Practice Address - State:TX
Practice Address - Zip Code:77446
Practice Address - Country:US
Practice Address - Phone:936-261-1410
Practice Address - Fax:936-857-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTSBNE#00496261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health