| Community Action Corporation Of South Texas | |
|
115 W Main St Benavides TX 78341 | |
| (361) 256-3663 | |
| (361) 664-2248 |
| Full Name | Community Action Corporation Of South Texas |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 W Main St, Benavides, Texas |
| Authorized Official Name and Position | Ann Awalt (EXECUTIVE DRIECTOR) |
| Authorized Official Contact | 3616640145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Action Corporation Of South Texas 204 E 1st St Alice TX 78332-4822 Ph: (361) 664-0145 | Community Action Corporation Of South Texas 115 W Main St Benavides TX 78341 Ph: (361) 256-3663 |
| NPI Number | 1609010131 |
|---|---|
| Provider Enumeration Date | 04/28/2009 |
| Last Update Date | 10/04/2013 |
| Medicare PECOS PAC ID | 9032003504 |
|---|---|
| Medicare Enrollment ID | O20090914000688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609010131 | NPI | - | NPPES |
| 205219301 | Medicaid | TX | |
| 00QW12 | Other | TX | MEDICARE- UNSPEICIED TYPR ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L5201 (Texas) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |