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2202 N Bryan Ave Lamesa TX 79331-2451 | |
(806) 872-6525 | |
(806) 872-6550 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 2202 N Bryan Ave, Lamesa, Texas |
Authorized Official Name and Position | Jim Roberts (OFFICE MANAGER) |
Authorized Official Contact | 8068726525 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2202 N Bryan Ave Lamesa TX 79331-2451 Ph: (806) 872-6525 | 2202 N Bryan Ave Lamesa TX 79331-2451 Ph: (806) 872-6525 |
NPI Number | 1699712190 |
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Provider Enumeration Date | 06/01/2006 |
Last Update Date | 09/21/2010 |
Identifier | Type | State | Issuer |
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1699712190 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | F4793 (Texas) | Primary |
Griengsak Chowpaknam Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 N Bryan Ave, Lamesa, TX 79331 Phone: 806-796-0507 Fax: 806-799-6908 | |