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921 E 4th St Monahans TX 79756-4016 | |
(432) 943-2511 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 921 E 4th St, Monahans, Texas |
Authorized Official Name and Position | Leticia Cazares Rodriguez (CEO) |
Authorized Official Contact | 4329432511 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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406 S Gary Ave Monahans TX 79756-4799 Ph: (432) 943-2511 | 921 E 4th St Monahans TX 79756-4016 Ph: (432) 943-2511 |
NPI Number | 1154805687 |
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Provider Enumeration Date | 09/20/2018 |
Last Update Date | 10/19/2018 |
Medicare PECOS PAC ID | 1456261494 |
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Medicare Enrollment ID | O20190110001720 |
Identifier | Type | State | Issuer |
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1154805687 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |