Full Name | |
---|---|
Speciality | Clinic/center |
Location | 917 Gober St, Paducah, Texas |
Authorized Official Name and Position | Holly Holcomb (CEO) |
Authorized Official Contact | 9409379178 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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901 Us Highway 83 N Childress TX 79201-2320 Ph: (940) 937-9178 | 917 Gober St Paducah TX 79248 Ph: (940) 637-9178 |
NPI Number | 1619493954 |
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Provider Enumeration Date | 08/18/2017 |
Last Update Date | 05/25/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619493954 | NPI | - | NPPES |
450369 | Other | TX | MEDICARE OSCAR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |