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886 E Lennon Dr Ste 105 Emory TX 75440-3214 | |
(903) 473-3036 | |
(903) 473-2007 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 886 E Lennon Dr, Emory, Texas |
Authorized Official Name and Position | Mary Ann Harrison (PROVIDER ENROLLMENT COORDINATOR) |
Authorized Official Contact | 9035101113 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 840698 Dallas TX 75284-6098 Ph: (903) 324-6450 | 886 E Lennon Dr Ste 105 Emory TX 75440-3214 Ph: (903) 473-3036 |
NPI Number | 1316061013 |
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Provider Enumeration Date | 03/19/2007 |
Last Update Date | 04/20/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316061013 | NPI | - | NPPES |
CP0098 | Other | TX | RAILROAD MEDICARE |
137940601 | Medicaid | TX | |
0030PS | Other | TX | BCBS GROUP |
177294904 | Medicaid | TX | |
184554701 | Medicaid | TX | |
091888002 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Hunt Memorial Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1080 E Lennon Dr Ste 3, Emory, TX 75440 Phone: 903-473-2060 |