| Community Healthcare Center-dental | |
|
110 Lee Street Wichita Falls TX 76301-1152 | |
| (940) 766-6306 | |
| (940) 766-6504 |
| Full Name | Community Healthcare Center-dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 Lee Street, Wichita Falls, Texas |
| Authorized Official Name and Position | Allen Patterson, Chief Executive Officer (CEO) |
| Authorized Official Contact | 9407666306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Healthcare Center-dental 200 Martin Luther King Blvd Wichita Falls TX 76301-1152 Ph: (940) 766-6306 | Community Healthcare Center-dental 110 Lee Street Wichita Falls TX 76301-1152 Ph: (940) 766-6306 |
| NPI Number | 1083045454 |
|---|---|
| Provider Enumeration Date | 12/10/2013 |
| Last Update Date | 04/06/2020 |
| Medicare PECOS PAC ID | 9931099215 |
|---|---|
| Medicare Enrollment ID | O20220510002686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083045454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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