MEDICARE: COUNTY OF YOAKUM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	008086	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093706442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF YOAKUM

Provider Business Mailing Address
First Line	:	500 W 5TH ST
Second Line	:
City	:	DENVER CITY
State	:	TX
Zip	:	79323-2706
Country	:	US
Telephone Number	:	806-592-2090
Fax Number	:	806-592-2341

Provider Business Practice Location Address
First Line	:	500 W 5TH ST
Second Line	:
City	:	DENVER CITY
State	:	TX
Zip	:	79323-2706
Country	:	US
Telephone Number	:	806-592-2090
Fax Number	:	806-592-2341

Authorized Official
Title or Position	:	INTERIM CEO, CFO
Name	:	SUANN PARRISH
Credential	:
Telephone Number	:	806-639-8254

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	09/03/2025

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Directions to “COUNTY OF YOAKUM ” Practice Location

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