Provider Demographics
NPI:1881219079
Name:HERE NOT THERE HEALTHCARE
Entity Type:Organization
Organization Name:HERE NOT THERE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:806-731-0108
Mailing Address - Street 1:PO BOX 503
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:TX
Mailing Address - Zip Code:79059-0503
Mailing Address - Country:US
Mailing Address - Phone:806-731-0108
Mailing Address - Fax:
Practice Address - Street 1:110B S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:TX
Practice Address - Zip Code:79059-3050
Practice Address - Country:US
Practice Address - Phone:806-731-0108
Practice Address - Fax:806-731-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty