Provider Demographics
NPI:1124782875
Name:NAVARRO COUNTY AMBULATORY CARE ASSOCIATION
Entity type:Organization
Organization Name:NAVARRO COUNTY AMBULATORY CARE ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUMMERALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-851-0727
Mailing Address - Street 1:618 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-3028
Mailing Address - Country:US
Mailing Address - Phone:903-851-7031
Mailing Address - Fax:903-872-7215
Practice Address - Street 1:618 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-3028
Practice Address - Country:US
Practice Address - Phone:903-874-6731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)