NPI | 1306234521 |
---|---|
Doing Business As | WACO FAMILY MEDICINE - SANTA FE |
Entity Type | Organization |
Authorized Contact | MATTHEW POLK Chief Operating Officer 254-313-4412 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2014-12-23 |
Last Update Date | 2025-04-09 |