Organization
LIBERTY MEDICAL RURAL HEALTH CLINIC
Active
Organization
LIBERTY MEDICAL RURAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FALLON BROOKE KAY (OFFICE MANAGER)
(936) 336-6439
Entity
Organization
Contact information
Practice address
720 TRAVIS ST, LIBERTY, TX 77575-4828
(936) 336-6439
(936) 336-6517
Mailing address
720 TRAVIS ST, LIBERTY, TX 77575-4828
(936) 336-6439
(936) 336-6517
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
453892
TX
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063414901
—
TX
01
—
CH8297
RR MEDICARE-RH
TX
Enumeration date
07/07/2005
Last updated
10/09/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up