| Grace Family Medicine Pllc | |
|
712 N Houston Ave Ste A New Braunfels TX 78130-4132 | |
| (830) 660-6166 | |
| Not Available |
| Full Name | Grace Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 712 N Houston Ave Ste A, New Braunfels, Texas |
| Authorized Official Name and Position | John Young Lee (OWNER) |
| Authorized Official Contact | 8303582224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Family Medicine Pllc 712 N Houston Ave Ste A New Braunfels TX 78130-4132 Ph: (830) 660-6166 | Grace Family Medicine Pllc 712 N Houston Ave Ste A New Braunfels TX 78130-4132 Ph: (830) 660-6166 |
| NPI Number | 1972115848 |
|---|---|
| Provider Enumeration Date | 08/20/2020 |
| Last Update Date | 09/22/2020 |
| Medicare PECOS PAC ID | 7719306661 |
|---|---|
| Medicare Enrollment ID | O20200928000978 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972115848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255367108 PECOS PAC ID: 6002897667 Enrollment ID: I20091230000678 |
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