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29099 Fm 106 Rio Hondo TX 78583-0256 | |
(956) 748-2381 | |
(956) 748-4256 |
Full Name | |
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Speciality | Clinic/Center |
Location | 29099 Fm 106, Rio Hondo, Texas |
Authorized Official Name and Position | Cheryl Mae Dodson (OWNER) |
Authorized Official Contact | 9567482381 |
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 1354 Hwy 106 Rio Hondo TX 78583-1354 Ph: (956) 748-2381 | 29099 Fm 106 Rio Hondo TX 78583-0256 Ph: (956) 748-2381 |
NPI Number | 1972596740 |
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Provider Enumeration Date | 08/26/2005 |
Last Update Date | 11/12/2024 |
Medicare PECOS PAC ID | 4880502285 |
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Medicare Enrollment ID | O20100416000733 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972596740 | NPI | - | NPPES |
157466701 | Medicaid | TX | |
157471701 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |