| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 207 East Court, Newton, Texas |
| Authorized Official Name and Position | Gloria D Jones (ADMINISTRATOR) |
| Authorized Official Contact | 4093792647 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
207 East Court Newton TX 75966 Ph: (409) 379-2647 | 207 East Court Newton TX 75966 Ph: (409) 379-2647 |
| NPI Number | 1124120928 |
|---|---|
| Provider Enumeration Date | 09/02/2006 |
| Last Update Date | 09/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124120928 | NPI | - | NPPES |
| 150074601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |