| Dlkpac Pllc | |
|
218 Park St Trinidad TX 75163-6060 | |
| (903) 778-2942 | |
| (903) 778-2177 |
| Full Name | Dlkpac Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 218 Park St, Trinidad, Texas |
| Authorized Official Name and Position | Deborah Kelley (OWNER) |
| Authorized Official Contact | 9037782942 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dlkpac Pllc 245 Lakeview Dr Trinidad TX 75163-2213 Ph: (414) 207-3506 | Dlkpac Pllc 218 Park St Trinidad TX 75163-6060 Ph: (903) 778-2942 |
| NPI Number | 1699324202 |
|---|---|
| Provider Enumeration Date | 09/06/2019 |
| Last Update Date | 09/06/2019 |
| Medicare PECOS PAC ID | 5991132250 |
|---|---|
| Medicare Enrollment ID | O20200226000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699324202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
John L Sawtelle Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 218 Park St, Trinidad, TX 75163 Phone: 903-778-2942 Fax: 903-778-2537 |