Provider Demographics
NPI:1740503887
Name:UNION TREATMENT CENTERS
Entity type:Organization
Organization Name:UNION TREATMENT CENTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR RCM DIVISION
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-323-6900
Mailing Address - Street 1:2206 E CENTRAL TEXAS EXPY
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-5315
Mailing Address - Country:US
Mailing Address - Phone:512-323-6900
Mailing Address - Fax:512-323-6903
Practice Address - Street 1:2206 E CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5315
Practice Address - Country:US
Practice Address - Phone:512-323-6900
Practice Address - Fax:512-323-6903
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION TREATMENT CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-03
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC7355111N00000X
111N00000X, 207Q00000X
TXH2243207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty