Provider Demographics
NPI:1184396665
Name:NORTHEAST TEXAS MIDWIFERY PLLC
Entity type:Organization
Organization Name:NORTHEAST TEXAS MIDWIFERY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DREIER
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:903-574-7646
Mailing Address - Street 1:413 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-4334
Mailing Address - Country:US
Mailing Address - Phone:903-708-2004
Mailing Address - Fax:903-767-4499
Practice Address - Street 1:413 W 1ST ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-4334
Practice Address - Country:US
Practice Address - Phone:903-708-2004
Practice Address - Fax:903-767-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-02
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing