| Ten Broeck Tennessee Physicians | |
|
11110 Woodson Drive Caldwell TX 77836-1053 | |
| (936) 567-2273 | |
| (936) 567-2274 |
| Full Name | Ten Broeck Tennessee Physicians |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 11110 Woodson Drive, Caldwell, Texas |
| Authorized Official Name and Position | Glenda F Guy (DIRECTOR, COMPLIANCE) |
| Authorized Official Contact | 9317832511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ten Broeck Tennessee Physicians 1 Medical Center Blvd Cookeville TN 38501-4294 Ph: (931) 783-2511 | Ten Broeck Tennessee Physicians 11110 Woodson Drive Caldwell TX 77836-1053 Ph: (936) 567-2273 |
| NPI Number | 1386285948 |
|---|---|
| Provider Enumeration Date | 10/04/2019 |
| Last Update Date | 12/11/2019 |
| Certification Date | 12/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386285948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |