Provider Demographics
NPI:1699332338
Name:ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS, INC.
Entity type:Organization
Organization Name:ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR PRACTICE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-556-3621
Mailing Address - Street 1:PO BOX 1819
Mailing Address - Street 2:
Mailing Address - City:LAMPASAS
Mailing Address - State:TX
Mailing Address - Zip Code:76550-0015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2401 WALKER PLACE BLVD
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-4025
Practice Address - Country:US
Practice Address - Phone:254-547-5516
Practice Address - Fax:254-542-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty