| |
717 N 4th St Longview TX 75601-5438 | |
(903) 753-0306 | |
(903) 753-0631 |
Full Name | |
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Speciality | Family Medicine |
Location | 717 N 4th St, Longview, Texas |
Authorized Official Name and Position | Deward Dewitt Mcdonald (PHYSICIAN/OFFICER) |
Authorized Official Contact | 9037530306 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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717 N 4th St Longview TX 75601-5438 Ph: (903) 753-0306 | 717 N 4th St Longview TX 75601-5438 Ph: (903) 753-0306 |
NPI Number | 1356679757 |
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Provider Enumeration Date | 11/23/2009 |
Last Update Date | 02/03/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356679757 | NPI | - | NPPES |
C5174 | Other | TX | STATE LISCENSE |
031317301 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | C5174 (Texas) | Primary |
Family Focus Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101b Woodbine Pl, Longview, TX 75601 Phone: 903-236-6222 Fax: 903-236-0808 | |
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Gail D Stockman Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 815 N 4th St, Suite A, Longview, TX 75601 Phone: 406-253-3430 |