| |
700 W Broadway St Fritch TX 79036-8754 | |
(806) 857-2311 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 700 W Broadway St, Fritch, Texas |
Authorized Official Name and Position | Donald Earl Bates (CEO) |
Authorized Official Contact | 8064675700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
100 Medical Dr Borger TX 79007-7579 Ph: (806) 467-5701 | 700 W Broadway St Fritch TX 79036-8754 Ph: (806) 857-2311 |
NPI Number | 1689872020 |
---|---|
Provider Enumeration Date | 07/06/2007 |
Last Update Date | 08/07/2024 |
Medicare PECOS PAC ID | 0042303232 |
---|---|
Medicare Enrollment ID | O20071214000640 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689872020 | NPI | - | NPPES |
1930042-01 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 008574 (Texas) | Primary |