Provider Demographics
NPI:1447257423
Name:UVALDE HEALTHCARE CLINICS
Entity type:Organization
Organization Name:UVALDE HEALTHCARE CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BUCKNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:830-278-6251
Mailing Address - Street 1:1025 GARNER FLD RD
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4809
Mailing Address - Country:US
Mailing Address - Phone:830-278-1692
Mailing Address - Fax:830-591-0623
Practice Address - Street 1:1025 GARNER FLD RD
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4809
Practice Address - Country:US
Practice Address - Phone:830-278-1692
Practice Address - Fax:830-591-0623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000063261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89180YOtherBCBS
TX458695Medicare ID - Type Unspecified