UPI (Provider ID): 10146
Change Report (if Any):

Short Name: NEW HOME

Long Name 1: NEW HOME DEVELOPMENT COMPANY
Long Name 2:

Address 1: 617 NORTH WALNUT SUITE 12
Address 2:

City: BRYAN
Zip Code: 43506
County: WILL

Contact: CAREN BAUER
Title: EX DR
Phone: 4195193075
FAX: 4195193042

Vendor: 10146

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/27/2011

File Produced: 19MAY2012