| Amd Medical Pllc | |
|
3500 Hillcrest Dr Ste 7 Waco TX 76708-3144 | |
| (254) 424-9523 | |
| (254) 424-9846 |
| Full Name | Amd Medical Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3500 Hillcrest Dr Ste 7, Waco, Texas |
| Authorized Official Name and Position | Jean Dortilus (PSYCHIATRIST) |
| Authorized Official Contact | 2544249523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amd Medical Pllc 3500 Hillcrest Dr Ste 7 Waco TX 76708-3144 Ph: (254) 424-9523 | Amd Medical Pllc 3500 Hillcrest Dr Ste 7 Waco TX 76708-3144 Ph: (254) 424-9523 |
| NPI Number | 1235797994 |
|---|---|
| Provider Enumeration Date | 05/29/2019 |
| Last Update Date | 05/27/2024 |
| Certification Date | 05/27/2024 |
| Medicare PECOS PAC ID | 6305170986 |
|---|---|
| Medicare Enrollment ID | O20190702001224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235797994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jean Nerva Dortilus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063658524 PECOS PAC ID: 8224362884 Enrollment ID: I20190702000762 |
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