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402 Mercer St Quanah TX 79252-4026 | |
(940) 663-2795 | |
(940) 663-5149 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 402 Mercer St, Quanah, Texas |
Authorized Official Name and Position | Charles Richard Slaton (PRESIDENT CEO) |
Authorized Official Contact | 9406635149 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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402 Mercer St Quanah TX 79252-4026 Ph: (940) 663-2795 | 402 Mercer St Quanah TX 79252-4026 Ph: (940) 663-2795 |
NPI Number | 1578891297 |
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Provider Enumeration Date | 11/19/2009 |
Last Update Date | 11/19/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578891297 | NPI | - | NPPES |
458848 | Other | TX | RURAL HEALTH CLINIC - FOARD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 000102 (Texas) | Primary |