| Henderson Family Medicine, Pllc | |
|
105 N High St Henderson TX 75652-3133 | |
| (903) 235-0086 | |
| (903) 657-1674 |
| Full Name | Henderson Family Medicine, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 105 N High St, Henderson, Texas |
| Authorized Official Name and Position | Tad Titlow (OWNER) |
| Authorized Official Contact | 9032350086 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Henderson Family Medicine, Pllc 105 N High St Henderson TX 75652-3133 Ph: (903) 235-0086 | Henderson Family Medicine, Pllc 105 N High St Henderson TX 75652-3133 Ph: (903) 235-0086 |
| NPI Number | 1831415793 |
|---|---|
| Provider Enumeration Date | 04/15/2010 |
| Last Update Date | 04/15/2010 |
| Medicare PECOS PAC ID | 7113059155 |
|---|---|
| Medicare Enrollment ID | O20110201000351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831415793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L1106 (Texas) | Primary |
| Provider Name | Tad W Titlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073725669 PECOS PAC ID: 0345310090 Enrollment ID: I20080606000235 |
| Provider Name | Upali S Walgama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265577175 PECOS PAC ID: 9436322187 Enrollment ID: I20111026000041 |
| Provider Name | Sally A Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003249558 PECOS PAC ID: 9335374248 Enrollment ID: I20131031001133 |
| Provider Name | Michael C Colotta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477824340 PECOS PAC ID: 7517199961 Enrollment ID: I20140417000346 |
| Provider Name | Alicia Juarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679258321 PECOS PAC ID: 2466816038 Enrollment ID: I20230914003260 |
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