| Athena Family Medicine | |
|
8301 Lakeview Pkwy Ste 106 Rowlett TX 75088-9319 | |
| (254) 717-9364 | |
| Not Available |
| Full Name | Athena Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 8301 Lakeview Pkwy Ste 106, Rowlett, Texas |
| Authorized Official Name and Position | Kevin Vo (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4694023434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Athena Family Medicine 810 Ralph Hall Pkwy 110 Rockwall TX 75032 Ph: (469) 402-3434 | Athena Family Medicine 8301 Lakeview Pkwy Ste 106 Rowlett TX 75088-9319 Ph: (254) 717-9364 |
| NPI Number | 1295189249 |
|---|---|
| Provider Enumeration Date | 04/15/2016 |
| Last Update Date | 08/30/2017 |
| Medicare PECOS PAC ID | 2163716259 |
|---|---|
| Medicare Enrollment ID | O20160812000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295189249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | P5246 (Texas) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | P5246 (Texas) | Secondary |
| Provider Name | Kevin Vo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063649846 PECOS PAC ID: 7517118011 Enrollment ID: I20121109000344 |
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