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720 Us Highway 259 N Ore City TX 75683-5763 | |
(903) 968-2847 | |
(903) 968-8958 |
Full Name | |
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Speciality | Clinic/Center |
Location | 720 Us Highway 259 N, Ore City, Texas |
Authorized Official Name and Position | Mandy Lynn Perry (OWNER) |
Authorized Official Contact | 9039682847 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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720 Us Highway 259 N Ore City TX 75683-5763 Ph: (903) 968-2847 | 720 Us Highway 259 N Ore City TX 75683-5763 Ph: (903) 968-2847 |
NPI Number | 1023612777 |
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Provider Enumeration Date | 11/24/2020 |
Last Update Date | 09/14/2023 |
Medicare PECOS PAC ID | 9335556117 |
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Medicare Enrollment ID | O20210323000381 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023612777 | NPI | - | NPPES |
1694561564 | Other | AMERIGROUP | |
9363417 | Other | CIGNA | |
H000RJ8101 | Other | TX | BCBS |
431976602 | Medicaid | TX | |
431976602 | Other | TX | MEDICAID |
EB1820 | Other | RAILROAD PALMETTO |
Provider Name | Mandy Lynn Perry |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083238232 PECOS PAC ID: 9133533102 Enrollment ID: I20210203000280 |