Organization · Type 2 NPI

Good Shepherd Medical Center - Linden, Inc

Rural Health Clinic/Center · Jefferson, TX

NPI number 1114985876 Active

Practice location

903 N Walcott St
Jefferson, TX 75657-1128

Call (903) 665-9500 Map

Fax (903) 665-9501

Mailing address

404 N Kaufman St
Linden, TX 75563-5234

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

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William Louis CastlemanMassage Therapist Jefferson, TX NPI 1205953130

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NPI record

NPI: 1114985876
Entity type: Organization (Type 2)
Issued: May 3, 2006
Last updated: Jul 26, 2011
Status: Active
Subpart: Yes of Good Shepherd Medical Center - Linden, Inc

Other names

<unavail>
Good Shepherd Glenn-Garrett Clinic - Jefferson · doing business as

Authorized official

Mr. Ed D Banos
President
(903) 315-1811

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114985876

Good Shepherd Medical Center - Linden, Inc's National Provider Identifier is 1114985876, issued on May 3, 2006. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Jefferson, TX. The record was last updated on Jul 26, 2011.