Provider Demographics
NPI:1851849681
Name:WACO BIRTH CENTER & CLINIC
Entity Type:Organization
Organization Name:WACO BIRTH CENTER & CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KEEP
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, WHNP
Authorized Official - Phone:254-224-6062
Mailing Address - Street 1:1525 AUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76701-1711
Mailing Address - Country:US
Mailing Address - Phone:254-224-6062
Mailing Address - Fax:254-224-6223
Practice Address - Street 1:1525 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-1711
Practice Address - Country:US
Practice Address - Phone:254-224-6062
Practice Address - Fax:254-224-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing