CROCKETT MEDICAL CENTER CLINIC – NPI #1487155990
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CROCKETT MEDICAL CENTER CLINIC is a provider located in CROCKETT, TX. NPPES has assigned the NPI number 1487155990 to CROCKETT MEDICAL CENTER CLINIC on February 21, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CROCKETT MEDICAL CENTER CLINIC” is a dba name, the actual legal business name for this organization is CROCKETT MEDICAL CENTER, LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was previously updated about 8 years ago on Aug 28, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CROCKETT MEDICAL CENTER CLINIC below.

NPI Profile for
CROCKETT MEDICAL CENTER, LLC

NPI Number
1487155990
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CROCKETT MEDICAL CENTER, LLC
Doing Business As (dba): CROCKETT MEDICAL CENTER CLINIC
Primary location
1050 E LOOP 304
CROCKETT, TX 75835
Phone: (936) 546-3890 Fax:
Mailing address
4220 BULL CREEK RD
AUSTIN, TX 78731-6026
Phone: (512) 617-7500 Fax:
Organization Subpart
No
Authorized Official
KELLY TJELMELAND
CEO
Phone: (512) 617-7500
Updated
Identifiers

Identifiers for CROCKETT MEDICAL CENTER CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDTX385139602
MEDICAIDTX385139603
MEDICAIDTX385139601
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.