China Community Clinic,LLC
Organization Active NPI Family Medicine Physician · China, TX
NPI 1891780656 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1891780656
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- F2352 (TX)
- Legal business name
- CHINA COMMUNITY CLINIC,LLC
- Practice address
- 415 N Broadway
China, TX 77613 - Phone
- (409) 752-2301
- Fax
- (409) 752-5054
- NPI assigned
- Sep 16, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Charles William Hall, PAC
- Title
- Manager/Pac
- Phone
- (409) 752-2301
Practitioners 3
-
Robby M. Eaves Jr., D.O.
-
Sommer Kolander Shackelford, DNP, APRN, FNP-C
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | F2352 | TX | Yes |
| Medical Physician Assistant |
363AM0700X | PA01495 | TX |
Addresses
Primary practice location
415 N Broadway
China, TX 77613
Mailing address
PO Box 786
China, TX 77613-0786
Phone (409) 752-2301
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8H1480 | Other | TX | MENDOZA BCBS # |
| 8N3373 | Other | TX | CHUCK HALL BCBS # |
| 880660 | Other | TX | BCBS # CLINIC |
| 0033JQ | Other | TX | CCC BCBS GROUP # |
Other providers in China, TX
- Angela Lynn Carlson
- China Community Clinic LLC
- Drugstore in China
- Kacey Erin Durden
- H&H China Pharmacy LLC
- Charles William Hall Sr.
- Hardin-Jefferson Isd
All providers in China, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.