| Mid Coast Wellcare - Ganado | |
|
204 4th Street Ganado TX 77962 | |
| (361) 771-3311 | |
| Not Available |
| Full Name | Mid Coast Wellcare - Ganado |
|---|---|
| Speciality | Clinic/Center |
| Location | 204 4th Street, Ganado, Texas |
| Authorized Official Name and Position | Anita M Crisp (VICE PRESIDENT PHYSICIAN SERVICES) |
| Authorized Official Contact | 9795435510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Coast Wellcare - Ganado 305 Sandy Corner Rd El Campo TX 77437-9535 Ph: (979) 543-5510 | Mid Coast Wellcare - Ganado 204 4th Street Ganado TX 77962 Ph: (361) 771-3311 |
| NPI Number | 1194349217 |
|---|---|
| Provider Enumeration Date | 06/04/2020 |
| Last Update Date | 02/03/2022 |
| Medicare PECOS PAC ID | 6406021765 |
|---|---|
| Medicare Enrollment ID | O20210608003459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194349217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Jackson Medical Clinic Of Ganado Physician Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 S. Third Street, Ganado, TX 77962 Phone: 361-771-3571 Fax: 361-771-3574 | |
W Sam Williams Jr Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 South 4th Street, Ganado, TX 77962 Phone: 361-771-3311 Fax: 361-771-3081 | |
Jackson Medical Clinic Of Ganado Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 S Third Street, Ganado, TX 77962 Phone: 361-771-3571 Fax: 361-771-3574 | |
Jackson Medical Clinic Of Ganado Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 S Third Street, Ganado, TX 77962 Phone: 361-771-3571 Fax: 361-771-3574 |