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1805 Industrial Way Clarksville TX 75426-2564 | |
(903) 428-0100 | |
(903) 428-0101 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1805 Industrial Way, Clarksville, Texas |
Authorized Official Name and Position | Melissa Puckett (OWNER) |
Authorized Official Contact | 9037150760 |
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 1021 Clarksville TX 75426-1021 Ph: (903) 428-0100 | 1805 Industrial Way Clarksville TX 75426-2564 Ph: (903) 428-0100 |
NPI Number | 1801367149 |
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Provider Enumeration Date | 12/16/2018 |
Last Update Date | 12/14/2023 |
Medicare PECOS PAC ID | 7618279530 |
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Medicare Enrollment ID | O20190204001634 |
Identifier | Type | State | Issuer |
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1801367149 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Angela D Ary |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689090854 PECOS PAC ID: 3072730720 Enrollment ID: I20140804002274 |
B. C. Muthappa, M.d., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 Farm Road 2825, Clarksville, TX 75426 Phone: 903-427-2201 | |
Core Health Systems Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 N Martin Luther King Dr, Clarksville, TX 75426 Phone: 903-427-2226 Fax: 903-427-3227 | |