| Epiphany Medical Services Pa | |
|
13810 Quaker Ave Lubbock TX 79424 | |
| (806) 576-3856 | |
| (806) 305-3348 |
| Full Name | Epiphany Medical Services Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 13810 Quaker Ave, Lubbock, Texas |
| Authorized Official Name and Position | Jeffrey Hannel (PRESIDENT) |
| Authorized Official Contact | 8065763856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Epiphany Medical Services Pa Po Box 65074 Lubbock TX 79464-5074 Ph: () - | Epiphany Medical Services Pa 13810 Quaker Ave Lubbock TX 79424 Ph: (806) 576-3856 |
| NPI Number | 1033963731 |
|---|---|
| Provider Enumeration Date | 04/17/2024 |
| Last Update Date | 04/17/2024 |
| Medicare PECOS PAC ID | 7810339702 |
|---|---|
| Medicare Enrollment ID | O20240523001197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033963731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeffrey W Hannel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790725182 PECOS PAC ID: 0143294371 Enrollment ID: I20040824000420 |
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Ttuhsc - Dme Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3601 4th St, Ste 2a100, Lubbock, TX 79430 Phone: 806-743-2898 Fax: 806-743-2787 |