| Ten Broeck Tennessee Physicians | |
|
100 W Cross St Madisonville TX 77864-2432 | |
| (936) 349-1671 | |
| (936) 349-1672 |
| Full Name | Ten Broeck Tennessee Physicians |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 100 W Cross St, Madisonville, Texas |
| Authorized Official Name and Position | Glenda F Guy (DIRECTOR COMPLIANCE) |
| Authorized Official Contact | 9317832511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ten Broeck Tennessee Physicians 100 W Cross St Madisonville TX 77864-2432 Ph: (936) 349-1671 | Ten Broeck Tennessee Physicians 100 W Cross St Madisonville TX 77864-2432 Ph: (936) 349-1671 |
| NPI Number | 1659919108 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 12/16/2019 |
| Certification Date | 12/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659919108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |