| Concho Valley Medicine, Llc | |
|
225 S Abe St San Angelo TX 76903-6305 | |
| (407) 414-6102 | |
| Not Available |
| Full Name | Concho Valley Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 225 S Abe St, San Angelo, Texas |
| Authorized Official Name and Position | Bryan A Mejia (PROVIDER) |
| Authorized Official Contact | 4074146102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Concho Valley Medicine, Llc 223 S Abe St San Angelo TX 76903-6305 Ph: (325) 374-0821 | Concho Valley Medicine, Llc 225 S Abe St San Angelo TX 76903-6305 Ph: (407) 414-6102 |
| NPI Number | 1225737539 |
|---|---|
| Provider Enumeration Date | 02/24/2023 |
| Last Update Date | 02/24/2023 |
| Medicare PECOS PAC ID | 9638536840 |
|---|---|
| Medicare Enrollment ID | O20230602001767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225737539 | NPI | - | NPPES |
| P9224 | Other | TX | TEXAS MEDICAL BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Bryan Armando Mejia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114107828 PECOS PAC ID: 3577719806 Enrollment ID: I20140319001312 |
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