Provider Demographics
NPI:1811165624
Name:FOX RURAL HEALTH CENTER
Entity type:Organization
Organization Name:FOX RURAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-937-9178
Mailing Address - Street 1:1501 S TAYLOR ST
Mailing Address - Street 2:TEXAS PANHANDLE FAMILY PLANNING AND HEALTH CENTERS
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-4307
Mailing Address - Country:US
Mailing Address - Phone:806-372-8731
Mailing Address - Fax:806-372-8746
Practice Address - Street 1:1001 US HIGHWAY 83 N
Practice Address - Street 2:TEXAS PANHANDLE FAMILY PLANNING AND HEALTH CENTERS
Practice Address - City:CHILDRESS
Practice Address - State:TX
Practice Address - Zip Code:79201-2322
Practice Address - Country:US
Practice Address - Phone:940-937-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOX RURAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-14
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5191261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111725101Medicaid