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1100 W Reynosa Street De Leon TX 76444 | |
(254) 893-5895 | |
(254) 893-5222 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1100 W Reynosa Street, De Leon, Texas |
Authorized Official Name and Position | Sherry L Hill (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2548935895 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1100 W Reynosa Ave De Leon TX 76444-1630 Ph: (254) 893-5895 | 1100 W Reynosa Street De Leon TX 76444 Ph: (254) 893-5895 |
NPI Number | 1669772117 |
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Provider Enumeration Date | 11/01/2010 |
Last Update Date | 03/25/2019 |
Identifier | Type | State | Issuer |
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1669772117 | NPI | - | NPPES |
126862503 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |