| David Heredia Md. Pa. | |
|
1500 Wildcat Dr Suite H Portland TX 78374-2825 | |
| (361) 777-3330 | |
| (361) 777-2811 |
| Full Name | David Heredia Md. Pa. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1500 Wildcat Dr, Portland, Texas |
| Authorized Official Name and Position | David Luis Heredia (PRESIDENT) |
| Authorized Official Contact | 3612299116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Heredia Md. Pa. 1500 Wildcat Dr Suite H Portland TX 78374-2825 Ph: (361) 777-3330 | David Heredia Md. Pa. 1500 Wildcat Dr Suite H Portland TX 78374-2825 Ph: (361) 777-3330 |
| NPI Number | 1740456821 |
|---|---|
| Provider Enumeration Date | 05/07/2008 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 5799768099 |
|---|---|
| Medicare Enrollment ID | O20080905000631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740456821 | NPI | - | NPPES |
| 196700201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L8073 (Texas) | Primary |
| Provider Name | David L Heredia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104980408 PECOS PAC ID: 9234112731 Enrollment ID: I20040607001519 |
Darryl Dewitt Collins, M.d.,p.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 213 Cedar Dr, Suite A, Portland, TX 78374 Phone: 361-777-2886 Fax: 361-777-3667 | |
Jerome Lee Sang Md, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 Cedar Dr, Portland, TX 78374 Phone: 361-643-6623 | |
Bridge Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 616 Elm St, Portland, TX 78374 Phone: 361-977-2059 | |
Coastal Plains Community Mhmr Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Marriott Dr, Portland, TX 78374 Phone: 361-777-3991 | |
Charles C. Gregory, Do Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1500 Wildcat Dr Ste C, Portland, TX 78374 Phone: 361-643-9800 Fax: 361-643-5112 | |
Mcjv Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 614 Elm St, Portland, TX 78374 Phone: 361-563-2966 |