Provider Demographics
NPI:1659461788
Name:JASPER NEWTON COUNTY PUBLIC HEALTH DISTRICT
Entity Type:Organization
Organization Name:JASPER NEWTON COUNTY PUBLIC HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACKIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:409-384-6829
Mailing Address - Street 1:139 WEST LAMAR ST.
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-4014
Mailing Address - Country:US
Mailing Address - Phone:409-384-6829
Mailing Address - Fax:409-384-4770
Practice Address - Street 1:139 WEST LAMAR ST.
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4014
Practice Address - Country:US
Practice Address - Phone:409-384-6829
Practice Address - Fax:409-384-4770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1391955Medicaid