| |
Rr 1 Box 17 907 E. Hill St Spur TX 79370-9302 | |
(806) 271-3306 | |
(806) 271-4256 |
Full Name | |
---|---|
Speciality | Clinic/center |
Location | Rr 1 Box 17, Spur, Texas |
Authorized Official Name and Position | Glenda White (ADMINISTRATOR) |
Authorized Official Contact | 8062713306 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Rr 1 Box 17 907 E. Hill St Spur TX 79370-9302 Ph: (806) 271-3306 | Rr 1 Box 17 907 E. Hill St Spur TX 79370-9302 Ph: (806) 271-3306 |
NPI Number | 1336322247 |
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Provider Enumeration Date | 12/13/2007 |
Last Update Date | 12/18/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336322247 | NPI | - | NPPES |
86930N | Other | TX | MEDICARE |
F3709 | Other | TX | MEDICAL LICENCE |
00081N | Other | TX | MEDICARE GROUP |
1275617177 | Other | TX | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | F3709 (Texas) | Primary |