| Fchc Rucker Clinic | |
|
200 N Pearl St Mart TX 76664-1142 | |
| (254) 803-3561 | |
| (254) 883-6066 |
| Full Name | Fchc Rucker Clinic |
|---|---|
| Speciality | General Practice |
| Location | 200 N Pearl St, Mart, Texas |
| Authorized Official Name and Position | Jessica Ford (INTERIM ADMINISTRATOR) |
| Authorized Official Contact | 2548033561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fchc Rucker Clinic Po Box 60 Marlin TX 76661-0060 Ph: (254) 803-3561 | Fchc Rucker Clinic 200 N Pearl St Mart TX 76664-1142 Ph: (254) 803-3561 |
| NPI Number | 1659593028 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 06/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659593028 | NPI | - | NPPES |
| 167931801 | Medicaid | TX | |
| 1679318-01 | Other | TX | PTAN |
| 167931802 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | E0892 (Texas) | Primary |
Rucker Clinic A Limestone Medical Center Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Pearl St, Mart, TX 76664 Phone: 254-729-3281 Fax: 254-729-3080 |