| Dewitt Family Care Clinic | |
|
1700 Rr 620 S Suite B Lakeway TX 78734-6245 | |
| (512) 263-9111 | |
| (512) 263-3122 |
| Full Name | Dewitt Family Care Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1700 Rr 620 S, Lakeway, Texas |
| Authorized Official Name and Position | Ronald Glenn Dewitt (OWNER) |
| Authorized Official Contact | 5122639111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dewitt Family Care Clinic 1700 Rr 620 S Suite B Lakeway TX 78734-6245 Ph: (512) 263-9111 | Dewitt Family Care Clinic 1700 Rr 620 S Suite B Lakeway TX 78734-6245 Ph: (512) 263-9111 |
| NPI Number | 1376735803 |
|---|---|
| Provider Enumeration Date | 08/17/2007 |
| Last Update Date | 08/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376735803 | NPI | - | NPPES |
| 00QM64 | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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