Bandera Family Practice | |
1050 Highway 16 South Bandera TX 78003 | |
(830) 796-7713 | |
(830) 796-7744 |
Full Name | Bandera Family Practice |
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Speciality | Internal Medicine |
Location | 1050 Highway 16 South, Bandera, Texas |
Authorized Official Name and Position | Ruth Frazier (EXECUTIVE ADMINISTRATOR) |
Authorized Official Contact | 8308165700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bandera Family Practice Po Box 2870 Bandera TX 78003-2870 Ph: (830) 796-7713 | Bandera Family Practice 1050 Highway 16 South Bandera TX 78003 Ph: (830) 796-7713 |
NPI Number | 1215025598 |
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Provider Enumeration Date | 10/11/2006 |
Last Update Date | 08/17/2018 |
Medicare PECOS PAC ID | 5294714580 |
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Medicare Enrollment ID | O20040719001620 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215025598 | NPI | - | NPPES |
1215025598 | Medicaid | TX | |
3347 | Other | TX | SUPERIOR HEALTH PLAN |
771 | Other | TX | COMMUNITY FIRST HEALTH |
10002909 | Other | TX | AMERIGROUP |
2132872 | Other | AETNA | |
191965261126 | Other | TX | HUMANA |
414865 | Other | TX | FIRST HEALTH/COVENTRY |
0055BY | Other | TX | BCBS OF TEXAS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | K0839 (Texas) | Primary |
Provider Name | Lawrence Alder |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023027182 PECOS PAC ID: 8022906882 Enrollment ID: I20040304001169 |
Provider Name | Gloria Lucia Ocampo |
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Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1417968306 PECOS PAC ID: 0941282578 Enrollment ID: I20040607000275 |
Provider Name | Richard K Newman |
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Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1447299912 PECOS PAC ID: 2365458809 Enrollment ID: I20060221000773 |
Provider Name | Rodrigo Crespo |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1609854090 PECOS PAC ID: 1658476601 Enrollment ID: I20070419000313 |
Provider Name | W Bryan Sims |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700822780 PECOS PAC ID: 9436244001 Enrollment ID: I20070927000878 |
Provider Name | Saleh N Jaafar |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1679564587 PECOS PAC ID: 3678519642 Enrollment ID: I20091207000467 |
Provider Name | Christodoulos S. Christodoulou |
---|---|
Provider Type | Practitioner - Allergy/immunology |
Provider Identifiers | NPI Number: 1700140969 PECOS PAC ID: 4688818792 Enrollment ID: I20130911000385 |
Provider Name | Auston J Myers |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1770861742 PECOS PAC ID: 5193940997 Enrollment ID: I20140711001103 |
Provider Name | Felix Maria Rodriguez Vargas |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619231826 PECOS PAC ID: 5597044024 Enrollment ID: I20171228001206 |
Provider Name | Kelly Lynn Nunemaker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629567896 PECOS PAC ID: 0042567224 Enrollment ID: I20180718003889 |
Provider Name | Joshua J Asamoa |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083145494 PECOS PAC ID: 3072883404 Enrollment ID: I20200603001590 |
Provider Name | Steven A Mercado |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043615503 PECOS PAC ID: 0345649570 Enrollment ID: I20210520001486 |
Provider Name | Laura E Oehler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508347766 PECOS PAC ID: 8224382676 Enrollment ID: I20210701000019 |
Provider Name | Tiffany Kay Headrick |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124780556 PECOS PAC ID: 3072901917 Enrollment ID: I20211027000228 |
Provider Name | Orrin K Mcleod |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972519759 PECOS PAC ID: 6103736079 Enrollment ID: I20230421001774 |
Provider Name | Mary Elizabeth Saenz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497481592 PECOS PAC ID: 6305206590 Enrollment ID: I20230719003418 |
Provider Name | Sarah Elizabeth Wiley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952173635 PECOS PAC ID: 2567811508 Enrollment ID: I20231215000667 |