Kickapoo Traditional Tribe of Texas
NPI #1821159518 in Eagle Pass, Texas
Provider Information
- NPI Number
- 1821159518
- Entity Type
- Organization
- Organization Name
- Kickapoo Traditional Tribe of Texas
- Primary Specialty
- Clinic/Center - Health Service
- Enumeration Date
- Dec 13, 2006
- Last Updated
- Mar 14, 2023
Practice Location
- Address
- 2192 ROSITA VALLEY ROAD
- City
- Eagle Pass
- State
- Texas
- ZIP Code
- 78852-9752
- Phone
- (830) 421-5349
Authorized Official
- Name
- JUANITA ELIZONDO
- Title
- OFFICE MANAGER
- Phone
- (830) 421-5903
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
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