Full Name | |
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Speciality | Clinic/Center |
Location | 600 Hwy 349 N, Iraan, Texas |
Authorized Official Name and Position | William Nall (ACTING CEO) |
Authorized Official Contact | 4326392575 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 665 Iraan TX 79744-0665 Ph: (432) 639-2575 | 600 Hwy 349 N Iraan TX 79744-0665 Ph: (432) 639-2575 |
NPI Number | 1174001242 |
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Provider Enumeration Date | 08/01/2018 |
Last Update Date | 10/10/2024 |
Medicare PECOS PAC ID | 9032023841 |
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Medicare Enrollment ID | O20181211002229 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174001242 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |