| Brown Family Health Center Inc | |
|
1407 E Main St Nacogdoches TX 75961-5369 | |
| (936) 569-8240 | |
| (936) 569-2217 |
| Full Name | Brown Family Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1407 E Main St, Nacogdoches, Texas |
| Authorized Official Name and Position | Yolanda Tatum (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9365698240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brown Family Health Center Inc Po Box 635022 Nacogdoches TX 75963-5022 Ph: (936) 569-8240 | Brown Family Health Center Inc 1407 E Main St Nacogdoches TX 75961-5369 Ph: (936) 569-8240 |
| NPI Number | 1851569024 |
|---|---|
| Provider Enumeration Date | 02/11/2008 |
| Last Update Date | 01/06/2021 |
| Medicare PECOS PAC ID | 8426003120 |
|---|---|
| Medicare Enrollment ID | O20050315001102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851569024 | NPI | - | NPPES |
| 673932 | Other | MEDICARE CCN | |
| 182721401 | Medicaid | TX | |
| 0092SG | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Lauren Gaudette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417979444 PECOS PAC ID: 7214911759 Enrollment ID: I20040614001243 |
| Provider Name | Carolyn L Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215111778 PECOS PAC ID: 4183700230 Enrollment ID: I20080328000706 |
| Provider Name | Olufemi T Oladele Ajose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205808318 PECOS PAC ID: 9537153259 Enrollment ID: I20120430000280 |
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