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7600 W State Highway 29 Suite 5 Georgetown TX 78628-6937 | |
| (512) 930-0363 | |
| (512) 930-0371 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 7600 W State Highway 29, Georgetown, Texas |
| Authorized Official Name and Position | Ann Nolen (OWNER/PRESIDENT) |
| Authorized Official Contact | 5129300363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2297 Georgetown TX 78627-2297 Ph: (512) 930-0363 | 7600 W State Highway 29 Suite 5 Georgetown TX 78628-6937 Ph: (512) 930-0363 |
| NPI Number | 1306959200 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 02/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306959200 | NPI | - | NPPES |
| 0051MN | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G1494 (Texas) | Primary |
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