| Beacon Integrated Healthcare | |
|
1250 S Runnels St De Kalb TX 75559-2317 | |
| (903) 280-8173 | |
| Not Available |
| Full Name | Beacon Integrated Healthcare |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1250 S Runnels St, De Kalb, Texas |
| Authorized Official Name and Position | Antonio Denard Ingram (FNP) |
| Authorized Official Contact | 9032808173 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Integrated Healthcare 118 Wood St Ofc 1 De Kalb TX 75559-2112 Ph: (903) 280-8173 | Beacon Integrated Healthcare 1250 S Runnels St De Kalb TX 75559-2317 Ph: (903) 280-8173 |
| NPI Number | 1023632619 |
|---|---|
| Provider Enumeration Date | 05/30/2020 |
| Last Update Date | 06/09/2020 |
| Certification Date | 06/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023632619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |