| Baylor Scott & White Clinic - Kingsland | |
|
105 Fm 2342 Kingsland TX 78639-6010 | |
| (325) 388-3515 | |
| (325) 388-9422 |
| Full Name | Baylor Scott & White Clinic - Kingsland |
|---|---|
| Speciality | Clinic/Center |
| Location | 105 Fm 2342, Kingsland, Texas |
| Authorized Official Name and Position | Timothy Ols (CEO) |
| Authorized Official Contact | 8302018679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baylor Scott & White Clinic - Kingsland Po Box 844658 Dallas TX 75284-4339 Ph: (254) 724-2111 | Baylor Scott & White Clinic - Kingsland 105 Fm 2342 Kingsland TX 78639-6010 Ph: (325) 388-3515 |
| NPI Number | 1730480393 |
|---|---|
| Provider Enumeration Date | 11/12/2010 |
| Last Update Date | 10/17/2019 |
| Medicare PECOS PAC ID | 6901117175 |
|---|---|
| Medicare Enrollment ID | O20191014000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730480393 | NPI | - | NPPES |
| 287274901 | Medicaid | TX | |
| 0042WF | Other | TX | BCBS |
| 287274902 | Other | TX | THSTEPS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 100090 (Texas) | Primary |
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