Provider Demographics
NPI:1881974616
Name:CACTUS HEALTH SERVICES, INC
Entity type:Organization
Organization Name:CACTUS HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:MECHELLE
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-290-2209
Mailing Address - Street 1:700 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT STOCKTON
Mailing Address - State:TX
Mailing Address - Zip Code:79735-5626
Mailing Address - Country:US
Mailing Address - Phone:432-336-8110
Mailing Address - Fax:833-415-1031
Practice Address - Street 1:700 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT STOCKTON
Practice Address - State:TX
Practice Address - Zip Code:79735-5626
Practice Address - Country:US
Practice Address - Phone:432-336-8110
Practice Address - Fax:833-415-1031
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CACTUS HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-24
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)