| Blanco Regional Clinic, P.a. | |
|
825 4th St Blanco TX 78606-4913 | |
| (830) 833-5581 | |
| (830) 833-4933 |
| Full Name | Blanco Regional Clinic, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 825 4th St, Blanco, Texas |
| Authorized Official Name and Position | John D Weaver (PRESIDENT) |
| Authorized Official Contact | 8308335581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blanco Regional Clinic, P.a. Po Box 1629 825 Fourth Street Blanco TX 78606-1629 Ph: (830) 833-5581 | Blanco Regional Clinic, P.a. 825 4th St Blanco TX 78606-4913 Ph: (830) 833-5581 |
| NPI Number | 1164547519 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 06/16/2008 |
| Medicare PECOS PAC ID | 6002825882 |
|---|---|
| Medicare Enrollment ID | O20060406000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164547519 | NPI | - | NPPES |
| 080001301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John Dudley Weaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841248408 PECOS PAC ID: 0446269229 Enrollment ID: I20100804001049 |
Healing Arts Community Health Center Of Blanco And Canyon Lake Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4520 S Us Highway 281, Blanco, TX 78606 Phone: 830-833-0510 Fax: 830-833-4307 |