| Advanced Medical Group | |
|
134 Menger Spgs Suite 1210 Boerne TX 78006-7218 | |
| (210) 698-9841 | |
| (210) 698-9863 |
| Full Name | Advanced Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 134 Menger Spgs, Boerne, Texas |
| Authorized Official Name and Position | Rachel A Sanchez (PRACTICE MANAGER) |
| Authorized Official Contact | 2106989841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Medical Group 24165 Ih 10 W Suite 217, Box 644 San Antonio TX 78257-1159 Ph: (210) 698-9841 | Advanced Medical Group 134 Menger Spgs Suite 1210 Boerne TX 78006-7218 Ph: (210) 698-9841 |
| NPI Number | 1366631020 |
|---|---|
| Provider Enumeration Date | 10/18/2007 |
| Last Update Date | 01/26/2013 |
| Medicare PECOS PAC ID | 5193888584 |
|---|---|
| Medicare Enrollment ID | O20090112000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366631020 | NPI | - | NPPES |
| CS5288 | Other | TX | MC RAILROAD GROUP TIN |
| 0088MC | Other | TX | BCBS GROUP ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G7947 (Texas) | Primary |
| Provider Name | David G Mata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790129815 PECOS PAC ID: 0749509263 Enrollment ID: I20150505002706 |
| Provider Name | Valerie M Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972080943 PECOS PAC ID: 4385997048 Enrollment ID: I20181025002122 |
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