| Arturo C. Taca, Jr., M.d. Llc | |
|
11477 Olde Cabin Rd Suite 210 Creve Coeur MO 63141 | |
| (314) 997-5208 | |
| (314) 997-5368 |
| Full Name | Arturo C. Taca, Jr., M.d. Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11477 Olde Cabin Rd, Creve Coeur, Missouri |
| Authorized Official Name and Position | Arturo Calvo Taca (MANAGER) |
| Authorized Official Contact | 3142591531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arturo C. Taca, Jr., M.d. Llc 1407 Bobolink Pl Brentwood MO 63144-1128 Ph: () - | Arturo C. Taca, Jr., M.d. Llc 11477 Olde Cabin Rd Suite 210 Creve Coeur MO 63141 Ph: (314) 997-5208 |
| NPI Number | 1891881140 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 02/17/2015 |
| Medicare PECOS PAC ID | 5092713941 |
|---|---|
| Medicare Enrollment ID | O20061201000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891881140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2006024384 (Missouri) | Primary |
| Provider Name | Arturo C Taca |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295846319 PECOS PAC ID: 9739187683 Enrollment ID: I20061201000234 |
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