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250 Mount Pleasant Rd Bogata TX 75417-2769 | |
(903) 577-2273 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 250 Mount Pleasant Rd, Bogata, Texas |
Authorized Official Name and Position | Terry Dean Scoggin (CEO) |
Authorized Official Contact | 9035776066 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2001 N Jefferson Ave Mount Pleasant TX 75455-2338 Ph: (903) 577-6000 | 250 Mount Pleasant Rd Bogata TX 75417-2769 Ph: (903) 577-2273 |
NPI Number | 1386401834 |
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Provider Enumeration Date | 03/01/2024 |
Last Update Date | 04/22/2024 |
Medicare PECOS PAC ID | 0143203257 |
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Medicare Enrollment ID | O20240312001479 |
Identifier | Type | State | Issuer |
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1386401834 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |