Family Doctor Clinic | |
6955 N Mesa St Ste 303c El Paso TX 79912-4442 | |
(915) 751-1675 | |
(915) 751-1675 |
Full Name | Family Doctor Clinic |
---|---|
Speciality | Family Medicine |
Location | 6955 N Mesa St, El Paso, Texas |
Authorized Official Name and Position | Tony Martinez (PRESIDENT) |
Authorized Official Contact | 9155848800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Family Doctor Clinic 7005 Alamosa Way El Paso TX 79912-1542 Ph: (915) 585-1443 | Family Doctor Clinic 6955 N Mesa St Ste 303c El Paso TX 79912-4442 Ph: (915) 751-1675 |
NPI Number | 1548245723 |
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Provider Enumeration Date | 12/12/2005 |
Last Update Date | 10/14/2007 |
Medicare PECOS PAC ID | 0042396202 |
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Medicare Enrollment ID | O20080327000773 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548245723 | NPI | - | NPPES |
085406082 | Other | TX | SS |
133420304 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | G1098 (Texas) | Primary |
Provider Name | Tony Martinez |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1831388396 PECOS PAC ID: 1456321801 Enrollment ID: I20040731000025 |
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