| Fredericksburg Clinic, Pllc | |
|
1308 South Highway 16 Fredericksburg TX 78624-5058 | |
| (830) 997-2181 | |
| (830) 997-9598 |
| Full Name | Fredericksburg Clinic, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1308 South Highway 16, Fredericksburg, Texas |
| Authorized Official Name and Position | John Radcliffe Kothmann (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8309972181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fredericksburg Clinic, Pllc 1308 South Highway 16 Fredericksburg TX 78624-5058 Ph: (830) 997-2181 | Fredericksburg Clinic, Pllc 1308 South Highway 16 Fredericksburg TX 78624-5058 Ph: (830) 997-2181 |
| NPI Number | 1033145545 |
|---|---|
| Provider Enumeration Date | 06/25/2006 |
| Last Update Date | 11/20/2017 |
| Medicare PECOS PAC ID | 3375515992 |
|---|---|
| Medicare Enrollment ID | O20040812000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033145545 | NPI | - | NPPES |
| 084372401 | Medicaid | TX | |
| 082891502 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Texas) | Primary |
| 207R00000X | Internal Medicine | (Texas) | Secondary |
| Provider Name | John R Kothmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780624502 PECOS PAC ID: 4385616903 Enrollment ID: I20040812000650 |
| Provider Name | Jennifer Kate Mayben |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194746685 PECOS PAC ID: 7113986035 Enrollment ID: I20041006001259 |
| Provider Name | Michael M Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386653236 PECOS PAC ID: 0345285227 Enrollment ID: I20050621001247 |
| Provider Name | Philip J Maple |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386688810 PECOS PAC ID: 5597772376 Enrollment ID: I20060320000567 |
| Provider Name | Jeffrey R Holt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700090826 PECOS PAC ID: 7911091160 Enrollment ID: I20070918000701 |
| Provider Name | Rebecca Daley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356348288 PECOS PAC ID: 6305903527 Enrollment ID: I20090316000195 |
| Provider Name | Emily J Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033366109 PECOS PAC ID: 0840343166 Enrollment ID: I20090804000876 |
| Provider Name | Leo C Tynan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811937303 PECOS PAC ID: 4183767965 Enrollment ID: I20100202000207 |
| Provider Name | Lisa M Kott-harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689057010 PECOS PAC ID: 4688973548 Enrollment ID: I20160427000431 |
| Provider Name | Maggie Klein Gainer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477901346 PECOS PAC ID: 8820381130 Enrollment ID: I20190930003055 |
| Provider Name | Aaron Dale Saul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184203002 PECOS PAC ID: 8224437272 Enrollment ID: I20210525002204 |
Fredericksburg Pulmonary Associates, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 West Windcrest, Suite 340, Fredericksburg, TX 78624 Phone: 830-997-1010 Fax: 830-997-1076 | |
Mark D Eden Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 820 Reuben St Ste B, Fredericksburg, TX 78624 Phone: 830-997-9497 Fax: 830-997-5677 | |
Pedernales Medical Group Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 W Windcrest St, Suite 310, Fredericksburg, TX 78624 Phone: 830-997-2191 Fax: 830-997-8202 | |
Joel Kneitz Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 W Windcrest St, Suite 250, Fredericksburg, TX 78624 Phone: 830-997-6000 Fax: 830-997-6040 | |
Mid-texas Health Care Assn., P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1305 N Milam St, Fredericksburg, TX 78624 Phone: 830-997-7626 Fax: 830-997-2641 | |
Cornerstone Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 514 W Windcrest St, Fredericksburg, TX 78624 Phone: 830-997-0330 |