| Gary R. Clayton, Md, Pa | |
|
740 Hospital Dr Suite 210 Beaumont TX 77701-4664 | |
| (409) 839-4757 | |
| (409) 839-4294 |
| Full Name | Gary R. Clayton, Md, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 740 Hospital Dr, Beaumont, Texas |
| Authorized Official Name and Position | Gary R Clayton (PRESIDENT) |
| Authorized Official Contact | 4098394757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary R. Clayton, Md, Pa Po Box 8235 Lumberton TX 77657-0235 Ph: (409) 839-4757 | Gary R. Clayton, Md, Pa 740 Hospital Dr Suite 210 Beaumont TX 77701-4664 Ph: (409) 839-4757 |
| NPI Number | 1750457164 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 11/05/2010 |
| Medicare PECOS PAC ID | 5092764324 |
|---|---|
| Medicare Enrollment ID | O20050113000672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750457164 | NPI | - | NPPES |
| 128406906 | Medicaid | TX | |
| 173193701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H5430 (Texas) | Primary |
| Provider Name | Gary R Clayton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154438620 PECOS PAC ID: 9436046562 Enrollment ID: I20040302001382 |
| Provider Name | Cesily Cormier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699032045 PECOS PAC ID: 9537309968 Enrollment ID: I20130709000318 |
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