HUNTSVILLE CLINIC, INC
Ambulatory Health at 10 St, Huntsville, TX

License number
Texas TX10096M
Category
Ambulatory Health
Type
Methadone
Owner
Name: MS. STACEY RAE HARRIS L.C.D.C.
Title: CEO/PROGRAM SPONSOR
Phone: (936) 524-2140
Address
Address
829 10Th St, Huntsville, TX 77320
National Provider ID: 1265615462
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HUNTSVILLE CLINIC, INC

829 10 St, Huntsville, TX 77320

Industry:
Medical Doctor's Office Specialty Hospital
Registration:
Aug 31, 1987
Phone:
(936) 291-9172 (Phone)
State ID:
0106057800
Business type:
Domestic For-Profit Corporation
Director, President:
Stacey R Harris (Director, President), 829 10 St, Huntsville, TX 77320
TIN:
17605219199

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