| Chcl Community Dental Clinic | |
|
1826 Parkway Dr Ste 500 Lubbock TX 79403-4406 | |
| (806) 687-6259 | |
| (806) 771-0850 |
| Full Name | Chcl Community Dental Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1826 Parkway Dr Ste 500, Lubbock, Texas |
| Authorized Official Name and Position | Michael P. Sullivan (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8067652611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chcl Community Dental Clinic 1610 5th St Lubbock TX 79401-2622 Ph: (806) 765-2611 | Chcl Community Dental Clinic 1826 Parkway Dr Ste 500 Lubbock TX 79403-4406 Ph: (806) 687-6259 |
| NPI Number | 1831118306 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 02/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831118306 | NPI | - | NPPES |
| 019021712 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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