Richard Vandegraaf, MD | |
102 N Magdalen St, San Angelo, TX 76903-5400 | |
(325) 481-2344 | |
Not Available |
Full Name | Richard Vandegraaf |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 102 N Magdalen St, San Angelo, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235624701 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | MT216889 (Pennsylvania) | Secondary |
208600000X | Surgery | U7073 (Texas) | Primary |
Entity Name | Shannon Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770587149 PECOS PAC ID: 0840103727 Enrollment ID: O20031222000702 |
Mailing Address | Practice Location Address |
---|---|
Richard Vandegraaf, MD 102 N Magdalen St, San Angelo, TX 76903-5400 Ph: (325) 481-2344 | Richard Vandegraaf, MD 102 N Magdalen St, San Angelo, TX 76903-5400 Ph: (325) 481-2344 |
Dr. Michael Keesey Boyd, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 102 N Magdalen St, San Angelo, TX 76903 Phone: 325-747-2344 | |
Emmette T Flynn, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 102 N Magdalen St, San Angelo, TX 76903 Phone: 325-658-1511 | |
Jess M Cornell, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 102 N Magdalen St, San Angelo, TX 76903 Phone: 325-658-1511 | |
Dr. Charles Leonard Cecil Iv, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 120 E Beauregard Ave, San Angelo, TX 76903 Phone: 325-481-2231 | |
William F Whitehead Iii, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 120 E Beauregard Ave, San Angelo, TX 76903 Phone: 325-658-1511 | |
John S Cargile Iii, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 102 N Magdalen St, San Angelo, TX 76903 Phone: 325-658-1511 |