SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER (NPI# 1215205265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215205265 |
Entity Type | Organization |
Organization Name | SHACKELFORD COUNTY COMMUNITY RESOURCE CENTER |
Other Organization Name | RESOURCECARE CLYDE |
Practice Address |
1712 North Access Road Clyde TX 79510 |
Mailing Address |
Po Box 2435 Albany TX 76430-8020 |
Practice Telephone | 3258934010 |
Practice Fax Number | 3258934035 |
Mailing Telephone | 3257622447 |
Mailing Fax Number | 3257622186 |
Enumeration Date | 2011-12-06 |
Last Update Date | 2012-10-30 |
Authorized Official Name | MRS. TINA LOUISE BETCHER (BILLING MANAGER/CREDENTIALER) |
Authorized Official Telephone | 3258934010 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
30117281979 | TX | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 287755701 | 05 |
Other Name | Type Code |
---|---|
ResourceCare Clyde | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194804278 | Shackelford County Community Resource Center | Clinic/Center | 725 Pate Street, Albany, TX 76430 | 2006-11-02 |
1184096273 | Shackelford County Community Resource Center | Clinic/Center | 217 Edwards, Merkel, TX 79536-3803 | 2015-10-28 |
1437551710 | Shackelford County Community Resource Center | Clinic/Center | 200 N Main St, Cross Plains, TX 76443-3312 | 2014-09-18 |
1417248824 | Shackelford County Community Resource Center | Clinic/Center | 2802 W Walker St, Breckenridge, TX 76424-4000 | 2011-04-20 |
1881985299 | Shackelford County Community Resource Center | Clinic/Center | 301 S Main St, Cross Plains, TX 76443-2581 | 2011-04-20 |
1073749784 | Shackelford County Community Resource Center | Clinic/Center | 128 W 4th St, Baird, TX 79504-5314 | 2009-06-09 |
Street Address |
1712 NORTH ACCESS ROAD |
City | CLYDE |
State | TX |
Zip Code | 79510 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578552857 | Trudy Lennette Smith | Physician Assistant | 1712 North Access Road, Clyde, TX 79510 | 2005-10-19 |
1730570698 | Pamela Williams | Counselor | 1712 North Access Road, Clyde, TX 79510-0679 | 2015-02-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093114688 | Rebecca A. Schowengerdt | Physician Assistant | 1712 N Access Road, Clyde, TX 79510 | 2014-08-19 |
1134425986 | Kameko Hazley Mcguire | Nurse Practitioner | 1712 N. Access Rd, Clyde, TX 79510 | 2011-01-26 |
1861680886 | Clyde Cons Isd | Local Education Agency (LEA) | 526 Shalimar, Clyde, TX 79510 | 2007-10-04 |
1003020058 | William Michael Walton | Dentist | 113 Hunt Street, Clyde, TX 79510 | 2007-05-09 |
1558411728 | Citizens Emergency Medical Service | Emergency Medical Technician, Paramedic | 815 South 2nd, Clyde, TX 79510 | 2007-01-11 |
1669775102 | Martin D Gonzalez | Nurse Practitioner | 1712 N Access Rd, Clyde, TX 79510 | 2010-12-06 |
1982642708 | Katherine Jean Robinson | Physician Assistant | 1712 N Access Rd, Clyde, TX 79510 | 2006-06-03 |
1023056272 | Billy W. Carpenter | Family Medicine | 1712 N Access Rd, Clyde, TX 79510 | 2006-06-02 |
1407960180 | Citizens Emergency Medical Service Inc. | Ambulance | 815 S. Second, Clyde, TX 79510-0000 | 2006-08-18 |
1962524298 | Cindy Kay Adams | Physical Therapist | 7451 Cr 254, 7451 Cr 254, Clyde, TX 79510-0246 | 2007-04-06 |
Find all providers in zip 79510 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1568075638 | Matagorda Episcopal Health Outreach Program | Clinic/Center | 2112 Regional Medical Center, Suite 1317, Wharton, TX 77488-9719 | 2020-08-28 |
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Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.