Organization
CHARLES W CADENHEAD M D
Active
Other names
Cadenhead Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES WAYNE CADENHEAD MD (OWNER)
(940) 864-2636
Entity
Organization
Contact information
Practice address
1417 NORTH 1ST ST SUITE A, HASKELL, TX 79521-0938
(940) 864-2636
(940) 864-3009
Mailing address
1417 NORTH 1ST ST SUITE A, HASKELL, TX 79521-0938
(940) 864-2636
(940) 864-3009
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
E4241
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0049RE
BLUE CROSS & BLUE SHIELD
TX
05
—
063645801
—
TX
05
—
1225468-01
—
TX
Enumeration date
06/24/2008
Last updated
10/09/2008
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