Provider Demographics
NPI:1245765163
Name:HHSC WIC PROGRAM
Entity type:Organization
Organization Name:HHSC WIC PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-341-4563
Mailing Address - Street 1:TEXAS HEALTH AND HUMAN SERVICES COMMISION PO BOX 149099
Mailing Address - Street 2:ARTS BILLING MC1470
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4616 W HOWARD LN STE 840
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-6300
Practice Address - Country:US
Practice Address - Phone:512-341-4598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS HEALTH AND HUMAN SERVICES COMMISION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy