Healthcare Provider Details
I. General information
NPI: 1811165624
Provider Name (Legal Business Name): FOX RURAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2008
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1001 US HIGHWAY 83 N TEXAS PANHANDLE FAMILY PLANNING AND HEALTH CENTERS
CHILDRESS TX
79201-2322
US
IV. Provider business mailing address
1501 S TAYLOR ST TEXAS PANHANDLE FAMILY PLANNING AND HEALTH CENTERS
AMARILLO TX
79101-4307
US
V. Phone/Fax
- Phone: 940-937-3636
- Fax:
- Phone: 806-372-8731
- Fax: 806-372-8746
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0005X |
| Taxonomy | Ambulatory Family Planning Facility |
| License Number | E5191 |
| License Number State | TX |
VIII. Authorized Official
Name:
HOLLY
HOLCOMB
Title or Position: CEO
Credential:
Phone: 940-937-9178