Outreach 12

NPI Provider: 1699771212
Contact Name: Webster-Neal Susan Jackie
Position: Program Director
Phone: (361) 568-3761

Outreach 12 Information:

Outreach 12 organization have npi 1699771212, taxonomy code is 261QR0405X with license number is 1918-A in . This Business address located in PO Box 147, Encino, TX 78353 Texas.

Practice Location
Address: 2208 Primrose Ave, McAllen, TX 78504
Phone: (956) 682-6889

Business Location
Address: PO Box 147, Encino, TX 78353
Phone: (361) 325-4921
Fax: (361) 325-5768

Taxonomy

Taxonomy Code: 261QR0405X

License Number: 1918-A

License Number of State: TX

Primary Taxonomy Switch: Y

Enumeration Date: 6/28/2005

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