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600 W Carrie Manor St Manor TX 78653-5035 | |
(512) 978-9780 | |
(512) 978-9781 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 600 W Carrie Manor St, Manor, Texas |
Authorized Official Name and Position | Kimberly Middleton (MANAGED CARE CONTRACT MANAGER) |
Authorized Official Contact | 5129789427 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 17366 Austin TX 78760-7366 Ph: (512) 978-9000 | 600 W Carrie Manor St Manor TX 78653-5035 Ph: (512) 978-9780 |
NPI Number | 1598793077 |
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Provider Enumeration Date | 06/30/2006 |
Last Update Date | 02/11/2021 |
Identifier | Type | State | Issuer |
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1598793077 | NPI | - | NPPES |
2046831-01 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |