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886 E Lennon Dr Suite 105 Emory TX 75440-3246 | |
(903) 473-2060 | |
(903) 473-2686 |
Full Name | |
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Speciality | Clinic/Center |
Location | 886 E Lennon Dr, Emory, Texas |
Authorized Official Name and Position | Steven Lee Boles (CEO) |
Authorized Official Contact | 9034085000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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501 Air Park Ave Greenville TX 75402-3000 Ph: (903) 408-1100 | 886 E Lennon Dr Suite 105 Emory TX 75440-3246 Ph: (903) 473-2060 |
NPI Number | 1699134882 |
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Provider Enumeration Date | 02/16/2016 |
Last Update Date | 01/31/2025 |
Medicare PECOS PAC ID | 7517137748 |
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Medicare Enrollment ID | O20140911000231 |
Identifier | Type | State | Issuer |
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1699134882 | NPI | - | NPPES |
673930 | Other | TX | CMS CERTIFICATION NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 673930 (Texas) | Primary |
Hunt Memorial Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1080 E Lennon Dr Ste 3, Emory, TX 75440 Phone: 903-473-2060 |