| Atascosa Health Center, Inc. | |
|
19010 Preist Blvd Lytle TX 78052-3486 | |
| (830) 772-9865 | |
| (830) 772-9821 |
| Full Name | Atascosa Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 19010 Preist Blvd, Lytle, Texas |
| Authorized Official Name and Position | Monty Small (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8305698940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atascosa Health Center, Inc. 310 W Oaklawn Rd Pleasanton TX 78064-4033 Ph: (830) 569-8940 | Atascosa Health Center, Inc. 19010 Preist Blvd Lytle TX 78052-3486 Ph: (830) 772-9865 |
| NPI Number | 1003359209 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 04/11/2022 |
| Medicare PECOS PAC ID | 3779579412 |
|---|---|
| Medicare Enrollment ID | O20170310000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003359209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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