institution
Canyon Lake Medical Clinic
Rural Health Clinic/Center in Canyon Lake, Texas
NPI 1124121009

Canyon Lake Medical Clinic is a Rural Health Clinic/Center based in Canyon Lake, TX and is specialized in Rural Health. Canyon Lake Medical Clinic practices in Canyon Lake, TX. The NPI Number for Canyon Lake Medical Clinic is 1124121009 and holds a License No. (Texas).

The current practice location address for Canyon Lake Medical Clinic is 1356 Fm 2673, Canyon Lake, TX and can be reached out via phone at 830-964-3019 and via fax at 830-226-5002.

Location: 1356 Fm 2673, Canyon Lake, TX, 78133-4510
institution
Provider Profile Details
NPI Number
1124121009
Provider Name
Canyon Lake Medical Clinic
Credential
Provider Entity Type
Organization
Address
1356 Fm 2673, Canyon Lake, TX, 78133-4510
Phone Number
830-964-3019
Fax Number
830-226-5002
Provider Enumeration Date
09/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
164301703 05 TX
0022HN 01 TX BLUE CROSS/BLUE SHIELD
164301702 05 TX
164301701 05 TX
institution
Provider Business Practice Location Address Details
Address
1356 Fm 2673
City
State
Zip
78133-4510
Phone Number
830-964-3019
Fax Number
830-226-5002
person
Provider Business Mailing Address Details
Address
1356 Fm 2673
City
State
Zip
78133-4510
Phone Number
830-964-3019
Fax Number
830-226-5002
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rural Health
Taxonomy
License No.
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Definition
Definition to come...
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