Look up the most recent NPI and PECOS records

Palo Pinto County Hospital District

(Palo Pinto Mobile Clinic)

Family Medicine

Allopathic & Osteopathic Physicians

400 SW 25th Ave, Mineral Wells, TX 76067-8246

PECOS Enrollment

Based on the most recent information from CMS, provider Palo Pinto County Hospital District does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1922056993
Provider Type
Organization
Full Name
Palo Pinto County Hospital District
Other Name
Palo Pinto Mobile Clinic

Subpart
No
Enumeration Date
5/4/2006
Last Updated
11/3/2023

Contact Information

Practice Location

400 SW 25th Ave, Mineral Wells, TX 76067-8246

(940) 325-7891

(940) 328-7529

Mailing Location

400 SW 25th Ave, Mineral Wells, TX 76067-8246

(940) 325-7891

(940) 328-6523

Authorized Official

Whiddon, William D (Cfo)

(940) 325-7891

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 000034 Texas
Code 207QA0505X	Description Family Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 207V00000X	Description Obstetrics & Gynecology Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID CD2070	Description Other	Issuer MEDICARE RAILROAD Texas
ID 085531402	Description Medicaid	Issuer Unlisted Texas
ID CC2933	Description Other	Issuer MEDICARE RAILROAD Texas

Palo Pinto County Hospital District

(Palo Pinto Mobile Clinic)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

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