Crockett Medical Center Clinic
LBN: Crockett Medical Center, Llc
Crockett Medical Center Clinic is an health care organization with primary practice located at 1050 E Loop 304 , Crockett TX 75835. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Crockett Medical Center, Llc can be contacted via phone (936) 546-3890, or through Tjelmeland, Kelly Eugene via phone (512) 617-7500.
Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | Texas | |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | Texas | |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | Texas | |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | Texas | |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | Texas | |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | Texas |
Profile Details
| NPI number | 1487155990 |
|---|---|
| LBN Legal business name | Crockett Medical Center, Llc |
| DBA Doing business as | Crockett Medical Center Clinic |
| Authorized official | Tjelmeland, Kelly Eugene |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 21st, 2018 |
| Last updated | Aug 28th, 2018 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487155990 | NPPES |
| Texas | MEDICAID | 385139603 | |
| Texas | MEDICAID | 385139602 | |
| Texas | MEDICAID | 385139601 |
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