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201 N Texas Ave Bryan TX 77803-5317 | |
| (979) 361-4440 | |
| (979) 823-2275 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 N Texas Ave, Bryan, Texas |
| Authorized Official Name and Position | Santos Navarrette (DIRECTOR) |
| Authorized Official Contact | 9793614440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
201 N Texas Ave Bryan TX 77803-5317 Ph: (979) 361-4440 | 201 N Texas Ave Bryan TX 77803-5317 Ph: (979) 361-4440 |
| NPI Number | 1144352881 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 01/17/2025 |
| Certification Date | 01/17/2025 |
| Medicare PECOS PAC ID | 5092965541 |
|---|---|
| Medicare Enrollment ID | O20121018000832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144352881 | NPI | - | NPPES |
| 209166235 | Other | TX | BLUE CROSS BLUE SHIELD |
| 1309825-04 | Medicaid | TX | |
| 1144352881 | Medicaid | TX |
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