| |
308 Ranch Road 2900 Kingsland TX 78639-6063 | |
(979) 543-5510 | |
Not Available |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 308 Ranch Road 2900, Kingsland, Texas |
Authorized Official Name and Position | David H Mak (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7135697370 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
305 Sandy Corner Rd El Campo TX 77437-9535 Ph: (979) 543-5510 | 308 Ranch Road 2900 Kingsland TX 78639-6063 Ph: (979) 543-5510 |
NPI Number | 1427635804 |
---|---|
Provider Enumeration Date | 03/24/2021 |
Last Update Date | 12/26/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427635804 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |