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625 8th St Somerville TX 77879-4585 | |
(979) 596-5840 | |
(979) 731-4570 |
Full Name | |
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Speciality | Clinic/Center |
Location | 625 8th St, Somerville, 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 College Station TX 77840-2600 Ph: (979) 383-2340 | 625 8th St Somerville TX 77879-4585 Ph: (979) 596-5840 |
NPI Number | 1437922366 |
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Provider Enumeration Date | 11/02/2023 |
Last Update Date | 09/11/2024 |
Medicare PECOS PAC ID | 4284542127 |
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Medicare Enrollment ID | O20240510001030 |
Identifier | Type | State | Issuer |
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1437922366 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |