| |
492 Springhill St Suite A Jasper TX 75951-4922 | |
(409) 381-5750 | |
(409) 384-2018 |
Full Name | |
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Speciality | Family Medicine |
Location | 492 Springhill St, Jasper, Texas |
Authorized Official Name and Position | Richard D Pham (OWNER) |
Authorized Official Contact | 4093815750 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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492 Springhill St Suite A Jasper TX 75951-4922 Ph: (409) 381-5750 | 492 Springhill St Suite A Jasper TX 75951-4922 Ph: (409) 381-5750 |
NPI Number | 1578755898 |
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Provider Enumeration Date | 08/10/2007 |
Last Update Date | 06/23/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578755898 | NPI | - | NPPES |
187770601 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | K2098 (Texas) | Primary |
Christus Jasper Memorial Hospital Family Practice Center - Jasper Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1276 S Peachtree St, Jasper, TX 75951 Phone: 361-887-9083 | |
Emd Health Centers Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203b S Main St, Jasper, TX 75951 Phone: 409-224-8289 | |