| Creekside Family Practice | |
|
1313 N Stagecoach Rd Salado TX 76571-5613 | |
| (254) 346-4029 | |
| (847) 221-6940 |
| Full Name | Creekside Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 1313 N Stagecoach Rd, Salado, Texas |
| Authorized Official Name and Position | Jennifer D Istre (OWNER) |
| Authorized Official Contact | 2543464029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Family Practice 112 N Main St Salado TX 76571-6454 Ph: (254) 346-4029 | Creekside Family Practice 1313 N Stagecoach Rd Salado TX 76571-5613 Ph: (254) 346-4029 |
| NPI Number | 1487237954 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 02/16/2022 |
| Medicare PECOS PAC ID | 6103226717 |
|---|---|
| Medicare Enrollment ID | O20210617002260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487237954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jennifer Istre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932496692 PECOS PAC ID: 7911255609 Enrollment ID: I20180813003156 |
| Provider Name | Marcie Marie Vasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184323230 PECOS PAC ID: 2264895697 Enrollment ID: I20230831002980 |
Little River Healthcare - Salado Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 Mill Creek Dr, Suite 180, Salado, TX 76571 Phone: 254-947-9044 |