Array Primary Care | |
1821 S Fm 51 Decatur TX 76234-3715 | |
(940) 233-6929 | |
Not Available |
Full Name | Array Primary Care |
---|---|
Speciality | Family Medicine |
Location | 1821 S Fm 51, Decatur, Texas |
Authorized Official Name and Position | Bryson Boyd (DIRECTOR) |
Authorized Official Contact | 9402336929 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Array Primary Care Po Box 1597 Bridgeport TX 76426-1597 Ph: () - | Array Primary Care 1821 S Fm 51 Decatur TX 76234-3715 Ph: (940) 233-6929 |
NPI Number | 1821850629 |
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Provider Enumeration Date | 01/26/2024 |
Last Update Date | 08/14/2024 |
Medicare PECOS PAC ID | 6103263991 |
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Medicare Enrollment ID | O20240328002990 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821850629 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Charles K Tibbels |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1871569632 PECOS PAC ID: 9234176314 Enrollment ID: I20050411000514 |
Provider Name | Johnathan Joel Swofford |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881105559 PECOS PAC ID: 9133487366 Enrollment ID: I20171218001056 |
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