| Elite Healthcare Services, Llc | |
|
190 Abner Jackson Pkwy Lake Jackson TX 77566-5169 | |
| (979) 529-2520 | |
| (979) 529-2537 |
| Full Name | Elite Healthcare Services, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 190 Abner Jackson Pkwy, Lake Jackson, Texas |
| Authorized Official Name and Position | Nancy Roman (PRESIDENT) |
| Authorized Official Contact | 9795292520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Healthcare Services, Llc 190 Abner Jackson Pkwy Lake Jackson TX 77566-5169 Ph: (979) 529-2520 | Elite Healthcare Services, Llc 190 Abner Jackson Pkwy Lake Jackson TX 77566-5169 Ph: (979) 529-2520 |
| NPI Number | 1194317156 |
|---|---|
| Provider Enumeration Date | 02/10/2021 |
| Last Update Date | 02/10/2021 |
| Medicare PECOS PAC ID | 4789099029 |
|---|---|
| Medicare Enrollment ID | O20210218000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194317156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Natalie Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629545462 PECOS PAC ID: 4385078674 Enrollment ID: I20191219000637 |
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