| Waco Family Medicine - Santa Fe | |
|
600 S 25th St Ste 115 Temple TX 76504-5227 | |
| (254) 899-8650 | |
| (254) 899-8669 |
| Full Name | Waco Family Medicine - Santa Fe |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 S 25th St Ste 115, Temple, Texas |
| Authorized Official Name and Position | Matthew Polk (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 2543134412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waco Family Medicine - Santa Fe 1600 Providence Dr Waco TX 76707-2261 Ph: (254) 313-4200 | Waco Family Medicine - Santa Fe 600 S 25th St Ste 115 Temple TX 76504-5227 Ph: (254) 899-8650 |
| NPI Number | 1306234521 |
|---|---|
| Provider Enumeration Date | 12/23/2014 |
| Last Update Date | 04/09/2025 |
| Certification Date | 04/09/2025 |
| Medicare PECOS PAC ID | 1153370242 |
|---|---|
| Medicare Enrollment ID | O20150224001396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306234521 | NPI | - | NPPES |
| 344169301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
| 207Q00000X | Family Medicine | (NU) | Secondary |
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