| Eastside Clinic & Wellness Center Pllc | |
|
2400 Wheless Ln Austin TX 78723-2016 | |
| (512) 363-5725 | |
| (512) 363-5901 |
| Full Name | Eastside Clinic & Wellness Center Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2400 Wheless Ln, Austin, Texas |
| Authorized Official Name and Position | Abraham Leija (OFFICE MANAGER) |
| Authorized Official Contact | 5125740228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Clinic & Wellness Center Pllc 2400 Wheless Ln Austin TX 78723-2016 Ph: (512) 363-5725 | Eastside Clinic & Wellness Center Pllc 2400 Wheless Ln Austin TX 78723-2016 Ph: (512) 363-5725 |
| NPI Number | 1811300163 |
|---|---|
| Provider Enumeration Date | 06/04/2014 |
| Last Update Date | 06/22/2023 |
| Medicare PECOS PAC ID | 0244450526 |
|---|---|
| Medicare Enrollment ID | O20141009000036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811300163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Graciela M Leija |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679674170 PECOS PAC ID: 7618948019 Enrollment ID: I20040802000042 |
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