| Stephenville Health Clinic, Llc | |
|
2287 Northwest Loop Stephenville TX 76401-1701 | |
| (254) 968-0411 | |
| Not Available |
| Full Name | Stephenville Health Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2287 Northwest Loop, Stephenville, Texas |
| Authorized Official Name and Position | Laranda Feemster (PRESIDENT) |
| Authorized Official Contact | 2549680411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephenville Health Clinic, Llc Po Box 2444 Stephenville TX 76401-0040 Ph: (254) 918-5388 | Stephenville Health Clinic, Llc 2287 Northwest Loop Stephenville TX 76401-1701 Ph: (254) 968-0411 |
| NPI Number | 1659947612 |
|---|---|
| Provider Enumeration Date | 06/01/2021 |
| Last Update Date | 06/15/2021 |
| Medicare PECOS PAC ID | 6507266244 |
|---|---|
| Medicare Enrollment ID | O20210616003312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659947612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Laranda Renee Feemster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487205464 PECOS PAC ID: 5799111837 Enrollment ID: I20200207001363 |
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