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Organization

COUNTY OF WARD

Active
Other names
Sandhills Family Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LETICIA RODRIGUEZ (CEO)
(432) 943-2511
Entity
Organization

Contact information

Practice address
813 E 4TH ST, MONAHANS, TX 79756-4015
(432) 943-2068
(432) 943-3114
Mailing address
PO BOX 40, MONAHANS, TX 79756-0040
(432) 943-2068
(432) 943-3114

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
000468
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0064HD
BLUE CROSS BLUE SHIELD TX
TX
01
092075302
CHIPS
TX
05
092075302
TX
01
105864100
FIRSTCARE SW HEALTH
TX
Enumeration date
08/04/2006
Last updated
01/28/2014
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