| Childrens Care a Van | |
|
300 S Colorado St Lockhart TX 78644-2700 | |
| (512) 398-1942 | |
| Not Available |
| Full Name | Childrens Care a Van |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 S Colorado St, Lockhart, Texas |
| Authorized Official Name and Position | William Davis (PRESIDENT & CEO) |
| Authorized Official Contact | 5123241000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Care a Van 1345 Philomena St Ste 362 Austin TX 78723-3185 Ph: (512) 324-9999 | Childrens Care a Van 300 S Colorado St Lockhart TX 78644-2700 Ph: (512) 398-1942 |
| NPI Number | 1144325481 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 01/28/2020 |
| Certification Date | 01/28/2020 |
| Medicare PECOS PAC ID | 5193634293 |
|---|---|
| Medicare Enrollment ID | O20061003000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144325481 | NPI | - | NPPES |
| 174708101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Texas) | Primary |
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