| Cornerstone Medical Rockwall Pllc | |
|
1201 Arista Dr Ste 105 Rockwall TX 75032-6860 | |
| (469) 987-4416 | |
| Not Available |
| Full Name | Cornerstone Medical Rockwall Pllc |
|---|---|
| Speciality | General Practice |
| Location | 1201 Arista Dr Ste 105, Rockwall, Texas |
| Authorized Official Name and Position | Chris Souder (CEO) |
| Authorized Official Contact | 4699874416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Medical Rockwall Pllc 1201 Arista Dr Ste 105 Rockwall TX 75032-6860 Ph: (469) 987-4416 | Cornerstone Medical Rockwall Pllc 1201 Arista Dr Ste 105 Rockwall TX 75032-6860 Ph: (469) 987-4416 |
| NPI Number | 1144986936 |
|---|---|
| Provider Enumeration Date | 11/16/2021 |
| Last Update Date | 11/16/2021 |
| Medicare PECOS PAC ID | 8729472402 |
|---|---|
| Medicare Enrollment ID | O20220222002116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144986936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Craig R Himmelsehr |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1467474890 PECOS PAC ID: 2961443080 Enrollment ID: I20050519000263 |
| Provider Name | Eric Isaac Ray |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1598965428 PECOS PAC ID: 2365625191 Enrollment ID: I20110331000483 |
| Provider Name | Julia R Roland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194211805 PECOS PAC ID: 5395094270 Enrollment ID: I20180827001448 |
| Provider Name | Doris Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912504648 PECOS PAC ID: 2163823980 Enrollment ID: I20210630000822 |
| Provider Name | Amber Street |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942974464 PECOS PAC ID: 6204213069 Enrollment ID: I20220517000493 |
| Provider Name | Lydia Alice Zajackowski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1104394824 PECOS PAC ID: 7911337035 Enrollment ID: I20240223002312 |
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