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712 Se 5th St Knox City TX 79529-2105 | |
(940) 657-3906 | |
(940) 657-3909 |
Full Name | |
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Speciality | Clinic/Center |
Location | 712 Se 5th St, Knox City, Texas |
Authorized Official Name and Position | Stephen A Kuehler (ADMINISTRATOR) |
Authorized Official Contact | 9406573535 |
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 488 Knox City TX 79529-0488 Ph: (940) 657-3906 | 712 Se 5th St Knox City TX 79529-2105 Ph: (940) 657-3906 |
NPI Number | 1134186356 |
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Provider Enumeration Date | 05/01/2006 |
Last Update Date | 11/06/2020 |
Medicare PECOS PAC ID | 5294643185 |
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Medicare Enrollment ID | O20030114000000 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134186356 | NPI | - | NPPES |
162520402 | Other | TX | TPI |
162520401 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |