| Dfw Diabetic Relief Llc | |
|
208 N Highway 377 Roanoke TX 76262-6170 | |
| (214) 929-7827 | |
| Not Available |
| Full Name | Dfw Diabetic Relief Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 208 N Highway 377, Roanoke, Texas |
| Authorized Official Name and Position | Eric Werner (OWNER) |
| Authorized Official Contact | 2149297827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfw Diabetic Relief Llc 3575 Lone Star Cir Ste 424 Fort Worth TX 76177-8908 Ph: (214) 929-7827 | Dfw Diabetic Relief Llc 208 N Highway 377 Roanoke TX 76262-6170 Ph: (214) 929-7827 |
| NPI Number | 1265120240 |
|---|---|
| Provider Enumeration Date | 04/27/2023 |
| Last Update Date | 04/27/2023 |
| Medicare PECOS PAC ID | 7214382738 |
|---|---|
| Medicare Enrollment ID | O20231018001282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265120240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Dwayne C Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316957574 PECOS PAC ID: 2365489390 Enrollment ID: I20050412000553 |
| Provider Name | Samantha N Pehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629210901 PECOS PAC ID: 5799961405 Enrollment ID: I20110513000541 |
| Provider Name | Abigail I Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356118616 PECOS PAC ID: 6507206422 Enrollment ID: I20240425002440 |
| Provider Name | Anna G Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033982780 PECOS PAC ID: 1759721442 Enrollment ID: I20240429001421 |
First Med Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1212 N Highway 377 Ste 119, Roanoke, TX 76262 Phone: 682-831-1591 | |
Kallal Bros, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1104 N Highway 377 Ste 200, Roanoke, TX 76262 Phone: 817-915-1520 | |
Rediclinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1228 N Highway 377, Roanoke, TX 76262 Phone: 866-607-7334 |