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General NPI Number Information
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NPI Number | 1447445887
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Entity Type | Organization
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Legal Business Name | FRED HEALTH CARE P L L C
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 20290 FM 92
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City | FRED
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State | TX
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Zip | 77616-0337
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Country | US
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Telephone | 409-980-9457
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 337
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City | FRED
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State | TX
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Zip | 77616-0337
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Country | US
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Telephone | 409-980-9457
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Fax |
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Authorized Official
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Title or Position | P.A. MANAGER
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Name | MR. KIM DONALD BEST
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Credential | P.A.
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Telephone | 409-429-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | PA 01322
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License Number State | TX
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