MEDICARE: HARTMAN COMMUNITY CLINIC PA

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	261QR1300X	Rural Health Clinic/Center

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932280542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARTMAN COMMUNITY CLINIC PA

Provider Business Mailing Address
First Line	:	4250 FIVE POINTS RD
Second Line	:	STE 14
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78410-4511
Country	:	US
Telephone Number	:	361-241-9600
Fax Number	:	361-241-9605

Provider Business Practice Location Address
First Line	:	103 S SOUTH ST
Second Line	:
City	:	MATHIS
State	:	TX
Zip	:	78368-2604
Country	:	US
Telephone Number	:	361-547-3203
Fax Number	:	361-547-3205

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SAMUEL CHRISTIAN HARTMAN
Credential	:	MD
Telephone Number	:	316-241-9600

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/01/2008

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Directions to “HARTMAN COMMUNITY CLINIC PA ” Practice Location

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