| |
1414 Arkansas Blvd, Texarkana, AR 71854-1604 | |
(870) 773-7246 | |
(870) 772-2568 |
Full Name | |
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Type | Facility |
Speciality | Family Medicine |
Location | 1414 Arkansas Blvd, Texarkana, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649237165 | NPI | - | NPPES |
152398002 | Medicaid | AR |
Provider Name | James D Raker |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1932103892 PECOS PAC ID: 9436044583 Enrollment ID: I20080408000739 |
Provider Name | Matthew Wayne Brandon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194115691 PECOS PAC ID: 6709795966 Enrollment ID: I20150325002374 |
Mailing Address | Practice Location Address |
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1414 Arkansas Blvd, Texarkana, AR 71854-1604 Ph: (870) 773-7246 | 1414 Arkansas Blvd, Texarkana, AR 71854-1604 Ph: (870) 773-7246 |