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120 Wood Ave Woodsboro TX 78393-0897 | |
(361) 543-5414 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 120 Wood Ave, Woodsboro, Texas |
Authorized Official Name and Position | Corey Wasicek (CEO) |
Authorized Official Contact | 3615262321 |
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 897 120 Wood Ave Woodsboro TX 78393-0897 Ph: (361) 543-5414 | 120 Wood Ave Woodsboro TX 78393-0897 Ph: (361) 543-5414 |
NPI Number | 1467495184 |
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Provider Enumeration Date | 06/13/2006 |
Last Update Date | 06/12/2024 |
Medicare PECOS PAC ID | 1153216783 |
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Medicare Enrollment ID | O20100608000078 |
Identifier | Type | State | Issuer |
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1467495184 | NPI | - | NPPES |
0925273-01 | Medicaid | TX | |
0925273-02 | Medicaid | TX |