| China Community Clinic,llc | |
|
415 N Broadway China TX 77613 | |
| (409) 752-2301 | |
| (409) 752-5054 |
| Full Name | China Community Clinic,llc |
|---|---|
| Speciality | Physician Assistant - Medical |
| Location | 415 N Broadway, China, Texas |
| Authorized Official Name and Position | Charles William Hall (MANAGER/PAC) |
| Authorized Official Contact | 4097522301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| China Community Clinic,llc Po Box 786 China TX 77613-0786 Ph: (409) 752-2301 | China Community Clinic,llc 415 N Broadway China TX 77613 Ph: (409) 752-2301 |
| NPI Number | 1891780656 |
|---|---|
| Provider Enumeration Date | 09/16/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891780656 | NPI | - | NPPES |
| 8H1480 | Other | TX | MENDOZA BCBS # |
| 8N3373 | Other | TX | CHUCK HALL BCBS # |
| 880660 | Other | TX | BCBS # CLINIC |
| 0033JQ | Other | TX | CCC BCBS GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | F2352 (Texas) | Primary |
| 363AM0700X | Physician Assistant - Medical | PA01495 (Texas) | Primary |
China Community Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 N Broadway, China, TX 77613 Phone: 409-752-2301 Fax: 409-752-5054 |