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1300 N 6th St Longview TX 75601-5567 | |
(903) 232-1785 | |
(903) 232-1782 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1300 N 6th St, Longview, Texas |
Authorized Official Name and Position | Kim Dale Nesvig (CEO) |
Authorized Official Contact | 9032340776 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2709 Longview TX 75606-2709 Ph: (903) 234-0776 | 1300 N 6th St Longview TX 75601-5567 Ph: (903) 232-1785 |
NPI Number | 1740783620 |
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Provider Enumeration Date | 03/16/2018 |
Last Update Date | 03/16/2018 |
Identifier | Type | State | Issuer |
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1740783620 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Texas) | Primary |
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