| Etmc Crockett Family Medical Center Rhc | |
|
1100 E Loop 304 Suite 200 Crockett TX 75835-1810 | |
| (936) 544-5132 | |
| (936) 544-3792 |
| Full Name | Etmc Crockett Family Medical Center Rhc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1100 E Loop 304, Crockett, Texas |
| Authorized Official Name and Position | Terry Cutler (ADMINISTRATOR) |
| Authorized Official Contact | 9365463862 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Etmc Crockett Family Medical Center Rhc Po Box 1304 Pittsburg TX 75686-2203 Ph: (936) 544-5132 | Etmc Crockett Family Medical Center Rhc 1100 E Loop 304 Suite 200 Crockett TX 75835-1810 Ph: (936) 544-5132 |
| NPI Number | 1962483453 |
|---|---|
| Provider Enumeration Date | 11/10/2005 |
| Last Update Date | 02/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962483453 | NPI | - | NPPES |
| 095181602 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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