| Organization Name: | CACTUS HEALTH SERVICES, INC |
| NPI Number: | 1881974616 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL CORKRUM (CEO) |
| Mailing Address: | 301 N Water St Fort Stockton |
| State: | TX US |
| Postal Code: | 797356814 |
| Phone Number: | 4323368110 |
| Fax Number: | 4323368107 |
| NPI Enumeration Date: | 08/24/2011 |
| NPI Last Update Date: | 05/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |