Provider Demographics
NPI:1780044545
Name:FCI BIG SPRING
Entity Type:Organization
Organization Name:FCI BIG SPRING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH SERVICES ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TELEISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRNKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:HSA
Authorized Official - Phone:432-466-2300
Mailing Address - Street 1:1900 SIMLER AVE
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-7789
Mailing Address - Country:US
Mailing Address - Phone:432-466-2438
Mailing Address - Fax:
Practice Address - Street 1:1900 SIMLER AVE
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-7789
Practice Address - Country:US
Practice Address - Phone:432-466-2438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal