Canyon Lake Medical Clinic in Canyon Lake - Rural Health
Canyon Lake Medical Clinic - NPI 1124121009
Canyon Lake Medical Clinic is a Rural Health in Canyon Lake, Texas. Canyon Lake Medical Clinic practices all healthcare services and medical treatments related to Rural Health. The NPI Number for Canyon Lake Medical Clinic is 1124121009. The last update date is 2011-08-25.
Canyon Lake Medical Clinic's current location address is 1356 Fm 2673, Canyon Lake, Texas. You can contact this provider via phone number 8309643019 and fax number 8302265002. The mailing address for Canyon Lake Medical Clinic is 1356 Fm 2673, Canyon Lake, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Canyon Lake Medical Clinic |
|---|---|
| Address | 1356 Fm 2673, Canyon Lake, Texas |
| Phone Number | 8309643019 |
| Fax Number | 8302265002 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Madison P Jeff |
| Telephone Number | 5124464500 |
NPI Number Detail
| NPI Number | 1124121009 |
|---|---|
| Provider Enumeration Date | 2006-09-06 |
| Last Updated Date | 2011-08-25 |
Provider Mailing Address Detail
| Address | 1356 Fm 2673 |
|---|---|
| City | Canyon Lake |
| State | Texas (TX) |
| Post Code | 781334510 |
| Phone Number | 8309643019 |
| Fax Number | 8302265002 |
Provider's Primary Taxonomy Detail
| Speciality | Rural Health |
|---|---|
| Taxonomy | 261Qr1300X |
|
Definition: Provides primary care and preventive health services in rural medically underserved areas. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 164301703 | TX | -- | |
| 0022HN | TX | BLUE CROSS/BLUE SHIELD | |
| 164301702 | TX | -- | |
| 164301701 | TX | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Canyon Lake Medical Clinic by the Centers for Medicare & Medicaid Services?
The Canyon Lake Medical Clinic has been assigned the NPI (National Provider Identifier) 1124121009. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Canyon Lake Medical Clinic is geographically located?
The Canyon Lake Medical Clinic is physically situated at the following location: 1356 Fm 2673, Canyon Lake, TX, 781334510.
What is Canyon Lake Medical Clinic's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Canyon Lake Medical Clinic is Rural Health, and the taxonomy code that categorizes this field of expertise is 261Qr1300X.
When did Canyon Lake Medical Clinic receive its 1124121009 assignment?
The Canyon Lake Medical Clinic was assigned its 1124121009 on 2006-09-06, which is the date when this unique identifier was issued to the organization.
When was the Canyon Lake Medical Clinic's information last updated?
The Canyon Lake Medical Clinic's information was last updated on 2011-08-25.
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