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1610 S Jefferson Ave Mount Pleasant TX 75455-5614 | |
(903) 572-2273 | |
(903) 572-0696 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1610 S Jefferson Ave, Mount Pleasant, 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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Po Box 511 Mount Pleasant TX 75456-0511 Ph: () - | 1610 S Jefferson Ave Mount Pleasant TX 75455-5614 Ph: (903) 572-2273 |
NPI Number | 1114548211 |
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Provider Enumeration Date | 04/29/2020 |
Last Update Date | 06/26/2024 |
Medicare PECOS PAC ID | 0143203257 |
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Medicare Enrollment ID | O20200707000596 |
Identifier | Type | State | Issuer |
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1114548211 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |