| Four Oaks Medical Clinic | |
|
109 Shult Dr Columbus TX 78934-3015 | |
| (979) 732-5794 | |
| (979) 732-5795 |
| Full Name | Four Oaks Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 109 Shult Dr, Columbus, Texas |
| Authorized Official Name and Position | James E. Vanek (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9794937650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Oaks Medical Clinic 109 Shult Dr Columbus TX 78934-3009 Ph: (979) 732-5794 | Four Oaks Medical Clinic 109 Shult Dr Columbus TX 78934-3015 Ph: (979) 732-5794 |
| NPI Number | 1932158367 |
|---|---|
| Provider Enumeration Date | 05/10/2006 |
| Last Update Date | 07/19/2022 |
| Medicare PECOS PAC ID | 1557250446 |
|---|---|
| Medicare Enrollment ID | O20100202000789 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932158367 | NPI | - | NPPES |
| 1268898-04 | Medicaid | TX | |
| 1268898-02 | Other | TX | EPSDT |
| 453415 | Other | TX | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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