Organization
PROVIDER HEALTHCARE SERVICES OF CONCHO LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRVIN DOUGLAS STRECKERT (ADMINISTRATOR)
(325) 869-5531
Entity
Organization
Contact information
Practice address
613 EAKER ST, EDEN, TX 76837
(325) 869-5531
(325) 869-5152
Mailing address
PO BOX 838, 613 EAKER ST, EDEN, TX 76837-0838
(325) 869-5531
(325) 869-5152
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
113535
TX
Other
Enumeration date
08/11/2005
Last updated
08/22/2020
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