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527 Peyton Street Baird TX 79504-5314 | |
(325) 854-1365 | |
(325) 854-1409 |
Full Name | |
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Speciality | Clinic/Center |
Location | 527 Peyton Street, Baird, Texas |
Authorized Official Name and Position | Tina L Betcher (BILLING MANAGER/CREDENTIALER) |
Authorized Official Contact | 3258934010 |
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 2435 Albany TX 76430-8020 Ph: (325) 762-2447 | 527 Peyton Street Baird TX 79504-5314 Ph: (325) 854-1365 |
NPI Number | 1073749784 |
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Provider Enumeration Date | 06/09/2009 |
Last Update Date | 11/23/2021 |
Medicare PECOS PAC ID | 8628027174 |
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Medicare Enrollment ID | O20090514000255 |
Identifier | Type | State | Issuer |
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1073749784 | NPI | - | NPPES |
171901505 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |