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3518 Fm 973 Del Valle TX 78617-3723 | |
(512) 978-9015 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 3518 Fm 973, Del Valle, Texas |
Authorized Official Name and Position | Joy Sloan (CFO) |
Authorized Official Contact | 5129789811 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 17366 Austin TX 78760-7366 Ph: (512) 978-9914 | 3518 Fm 973 Del Valle TX 78617-3723 Ph: (512) 978-9015 |
NPI Number | 1790296374 |
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Provider Enumeration Date | 10/23/2017 |
Last Update Date | 02/06/2025 |
Medicare PECOS PAC ID | 5395802151 |
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Medicare Enrollment ID | O20171208002078 |
Identifier | Type | State | Issuer |
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1790296374 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |