| Crockett Medical Center Clinic | |
|
1050 E Loop 304 Crockett TX 75835 | |
| (936) 546-3890 | |
| Not Available |
| Full Name | Crockett Medical Center Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1050 E Loop 304, Crockett, Texas |
| Authorized Official Name and Position | Kelly Eugene Tjelmeland (CEO) |
| Authorized Official Contact | 5126177500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crockett Medical Center Clinic 4220 Bull Creek Rd Austin TX 78731-6026 Ph: (512) 617-7500 | Crockett Medical Center Clinic 1050 E Loop 304 Crockett TX 75835 Ph: (936) 546-3890 |
| NPI Number | 1487155990 |
|---|---|
| Provider Enumeration Date | 02/21/2018 |
| Last Update Date | 08/28/2018 |
| Medicare PECOS PAC ID | 3173884152 |
|---|---|
| Medicare Enrollment ID | O20180316002045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487155990 | NPI | - | NPPES |
| 385139603 | Medicaid | TX | |
| 385139602 | Medicaid | TX | |
| 385139601 | Medicaid | TX |
| Provider Name | Craig S Yetter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164436168 PECOS PAC ID: 5991785784 Enrollment ID: I20040722000562 |
| Provider Name | James Cochran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154304467 PECOS PAC ID: 8224946389 Enrollment ID: I20050308000895 |
| Provider Name | James S Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821140906 PECOS PAC ID: 6608892815 Enrollment ID: I20051018000214 |
| Provider Name | Clifton B Omeara |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467405316 PECOS PAC ID: 9436172111 Enrollment ID: I20060109000581 |
| Provider Name | Robert A Launikitis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629272299 PECOS PAC ID: 9638222409 Enrollment ID: I20090728000273 |
| Provider Name | Jeffery D Kroll |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1073509188 PECOS PAC ID: 5092852541 Enrollment ID: I20100225000374 |
| Provider Name | Richard Tay |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790771715 PECOS PAC ID: 3173660628 Enrollment ID: I20100304000124 |
| Provider Name | Richard J Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376535419 PECOS PAC ID: 0941488803 Enrollment ID: I20110623000137 |
| Provider Name | Christopher R Haeckler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134111263 PECOS PAC ID: 6608049507 Enrollment ID: I20111108000817 |
| Provider Name | Edgar Milam |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154359545 PECOS PAC ID: 9133116254 Enrollment ID: I20170817003056 |
| Provider Name | Rajesh Ramineni |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1134320245 PECOS PAC ID: 6507177904 Enrollment ID: I20170906003539 |
| Provider Name | Robin L Yue |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144315417 PECOS PAC ID: 9638266133 Enrollment ID: I20190702001297 |
| Provider Name | Lora Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972060390 PECOS PAC ID: 5799962379 Enrollment ID: I20230327002777 |
| Provider Name | Charlotte G Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316640832 PECOS PAC ID: 2567837487 Enrollment ID: I20230406002257 |
| Provider Name | Mary Danielle Milligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588210033 PECOS PAC ID: 7214383645 Enrollment ID: I20231020002823 |
Crockett Medical Center Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1050 E Loop 304 Ste 201, Crockett, TX 75835 Phone: 936-546-3890 | |
Timberlands Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 E Loop 304, Suite 200, Crockett, TX 75835 Phone: 936-544-5132 | |
Rhpa Dba Iron Mountain Medical Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 N Grace St, Crockett, TX 75835 Phone: 936-544-7202 Fax: 936-546-2029 | |
Crockett Clinic Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1122 E Loop 304, Crockett, TX 75835 Phone: 936-544-2157 Fax: 936-544-5572 | |
D&c Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 Loop 3048 East, Suite 200, Crockett, TX 75835 Phone: 903-723-7178 Fax: 903-723-8252 | |
Texas Family Doctor, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 951 E Loop 304, Crockett, TX 75835 Phone: 936-655-0500 |