Provider Demographics
NPI:1669893095
Name:COVE FAMILY HEALTHCARE
Entity type:Organization
Organization Name:COVE FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:254-542-2440
Mailing Address - Street 1:PO BOX 121
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-0121
Mailing Address - Country:US
Mailing Address - Phone:254-542-2440
Mailing Address - Fax:254-518-2237
Practice Address - Street 1:1007 W HIGHWAY 190
Practice Address - Street 2:STE A
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-3886
Practice Address - Country:US
Practice Address - Phone:254-542-2440
Practice Address - Fax:254-518-2237
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COVE PHYSICAL REHAB, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty