Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 406 S Summer St, Marfa, Texas |
Authorized Official Name and Position | Linda Molinar (CEO) |
Authorized Official Contact | 4328374812 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1605 N Ft Davis Hwy Suite B Alpine TX 79830 Ph: (432) 837-4812 | 406 S Summer St Marfa TX 79843 Ph: (432) 729-1800 |
NPI Number | 1013196625 |
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Provider Enumeration Date | 10/31/2007 |
Last Update Date | 12/08/2022 |
Medicare PECOS PAC ID | 5193823045 |
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Medicare Enrollment ID | O20080513000038 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013196625 | NPI | - | NPPES |
189915501 | Medicaid | TX | |
67-1881 | Other | TX | MEDICARE CCN OR PTAN |