| Georgetown Family & Geriatric Medicine Pllc | |
|
103 Thousand Oaks Blvd Georgetown TX 78628-8757 | |
| (512) 869-4800 | |
| (512) 869-4807 |
| Full Name | Georgetown Family & Geriatric Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 103 Thousand Oaks Blvd, Georgetown, Texas |
| Authorized Official Name and Position | Rogelio Trevino (OWNER/PRESIDENT) |
| Authorized Official Contact | 5128694800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgetown Family & Geriatric Medicine Pllc 103 Thousand Oaks Blvd Georgetown TX 78628-8757 Ph: (512) 869-4800 | Georgetown Family & Geriatric Medicine Pllc 103 Thousand Oaks Blvd Georgetown TX 78628-8757 Ph: (512) 869-4800 |
| NPI Number | 1851538565 |
|---|---|
| Provider Enumeration Date | 01/16/2009 |
| Last Update Date | 01/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851538565 | NPI | - | NPPES |
| 0010SA | Other | TX | BCBSTX GROUP # |
| 201407801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Texas) | Primary |
| 207QG0300X | Family Medicine - Geriatric Medicine | (Texas) | Secondary |
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