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310 Hickory Street Calvert TX 77837 | |
(979) 364-2824 | |
(979) 731-4570 |
Full Name | |
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Speciality | Clinic/Center |
Location | 310 Hickory Street, Calvert, Texas |
Authorized Official Name and Position | Theresa Sabella (CEO) |
Authorized Official Contact | 9793832348 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1500 University Dr E Ste 100 College Station TX 77840-2600 Ph: () - | 310 Hickory Street Calvert TX 77837 Ph: (979) 364-2824 |
NPI Number | 1184302440 |
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Provider Enumeration Date | 07/07/2023 |
Last Update Date | 07/10/2024 |
Medicare PECOS PAC ID | 4284542127 |
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Medicare Enrollment ID | O20240531002231 |
Identifier | Type | State | Issuer |
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1184302440 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |