# FALLS COMMUNITY HOSPITAL AND CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FALLS COMMUNITY HOSPITAL AND CLINIC
- **Other names:** FCHC Rucker Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659593028
- **Legal business name:** FALLS COMMUNITY HOSPITAL AND CLINIC
- **Authorized official:** MRS. JESSICA FORD (INTERIM ADMINISTRATOR)
- **Authorized official phone:** (254) 803-3561

## Contact information

- **Practice address:** 200 N PEARL ST, MART, TX 76664-1142
- **Practice address phone:** (254) 803-3561
- **Practice address fax:** (254) 883-6066
- **Mailing address:** PO BOX 60, MARLIN, TX 76661-0060
- **Mailing address phone:** (254) 803-3561
- **Mailing address fax:** (254) 883-6066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | E0892 | TX | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 06/02/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1679318-01 | PTAN | TX |
| 05 | — | 167931801 | — | TX |
| 05 | — | 167931802 | — | TX |