| Genesis Gynecology Pa | |
|
176 Fairway Dr Kerrville TX 78028-6437 | |
| (830) 792-0805 | |
| (830) 792-0833 |
| Full Name | Genesis Gynecology Pa |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 176 Fairway Dr, Kerrville, Texas |
| Authorized Official Name and Position | Kerri Lee Truelock (PRESIDENT) |
| Authorized Official Contact | 8307920805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Gynecology Pa 176 Fairway Dr Kerrville TX 78028-6437 Ph: (830) 792-0805 | Genesis Gynecology Pa 176 Fairway Dr Kerrville TX 78028-6437 Ph: (830) 792-0805 |
| NPI Number | 1174792733 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 03/13/2013 |
| Medicare PECOS PAC ID | 2062582638 |
|---|---|
| Medicare Enrollment ID | O20080609000585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174792733 | NPI | - | NPPES |
| 0083RB | Other | TX | BCBS OF TEXAS GROUP # |
| 193308701 | Medicaid | TX |
| Provider Name | Kerri L Truelock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750344883 PECOS PAC ID: 4587609060 Enrollment ID: I20050624000485 |
| Provider Name | Kelly Pelton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356347868 PECOS PAC ID: 8224181193 Enrollment ID: I20090727000026 |
| Provider Name | Lori Gayle Pruitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316413255 PECOS PAC ID: 8123362381 Enrollment ID: I20181129001624 |
Kerrville Mec, Lp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 723 Hill Country Dr Ste C, Kerrville, TX 78028 Phone: 830-792-5800 Fax: 830-792-5848 | |
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