Clinica Hf Jupiter Llc | |
3516 W Walnut St Garland TX 75042-6234 | |
(469) 304-0074 | |
Not Available |
Full Name | Clinica Hf Jupiter Llc |
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Speciality | Family Medicine |
Location | 3516 W Walnut St, Garland, Texas |
Authorized Official Name and Position | Marsel Yousef (OWNER) |
Authorized Official Contact | 3462130377 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Clinica Hf Jupiter Llc 3516 W Walnut St Garland TX 75042-6234 Ph: (469) 304-0074 | Clinica Hf Jupiter Llc 3516 W Walnut St Garland TX 75042-6234 Ph: (469) 304-0074 |
NPI Number | 1164280244 |
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Provider Enumeration Date | 03/12/2024 |
Last Update Date | 10/15/2024 |
Medicare PECOS PAC ID | 4486187184 |
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Medicare Enrollment ID | O20241104000566 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164280244 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Rose Santiago Benny |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1043349756 PECOS PAC ID: 9335672450 Enrollment ID: I20241029000925 |
Provider Name | Daimel Perez Lopez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932974813 PECOS PAC ID: 4880127497 Enrollment ID: I20241104001341 |
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