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General NPI Number Information
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NPI Number | 1184942799
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Entity Type | Organization
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Legal Business Name | SHACKELFORD COUNTY HEALTH CLINIC
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 450 KENSHALO ST
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City | ALBANY
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State | TX
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Zip | 76430-3218
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Country | US
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Telephone | 325-762-3661
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Fax | 325-762-3859
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Provider Business Mailing Address
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Address Line | PO BOX 2470
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City | ALBANY
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State | TX
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Zip | 76430
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Country | US
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Telephone | 325-762-3661
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Fax | 325-762-3859
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Authorized Official
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Title or Position | DISTRICT ADMINISTRATOR
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Name | BRANDI GREEN
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Credential |
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Telephone | 325-762-3661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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