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917 Gober St Paducah TX 79248-1177 | |
(940) 663-2795 | |
(940) 663-5149 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 917 Gober St, Paducah, Texas |
Authorized Official Name and Position | Charles Richard Slaton (PRESIDENT CEO) |
Authorized Official Contact | 9406632795 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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917 Gober St Paducah TX 79248-1177 Ph: (940) 663-2795 | 917 Gober St Paducah TX 79248-1177 Ph: (940) 663-2795 |
NPI Number | 1487982104 |
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Provider Enumeration Date | 11/19/2009 |
Last Update Date | 11/19/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487982104 | NPI | - | NPPES |
458830 | Other | TX | RURAL HEALTH CLINIC PADUCAH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 000102 (Texas) | Primary |