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494 Springhill St Ste 200 Jasper TX 75951-5053 | |
(409) 489-4864 | |
(409) 489-4868 |
Full Name | |
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Speciality | Family Medicine |
Location | 494 Springhill St Ste 200, Jasper, Texas |
Authorized Official Name and Position | Jacklyn Robinson (PRACTICE MANAGER) |
Authorized Official Contact | 4095504198 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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494 Springhill St Ste 200 Jasper TX 75951-5053 Ph: () - | 494 Springhill St Ste 200 Jasper TX 75951-5053 Ph: (409) 489-4864 |
NPI Number | 1295200228 |
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Provider Enumeration Date | 10/05/2018 |
Last Update Date | 01/30/2024 |
Medicare PECOS PAC ID | 4587999818 |
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Medicare Enrollment ID | O20190709002625 |
Identifier | Type | State | Issuer |
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1295200228 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Reatha J Bradberry |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548219876 PECOS PAC ID: 3375613904 Enrollment ID: I20080609000167 |
Provider Name | Terri L Barnhart |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891081428 PECOS PAC ID: 8426219619 Enrollment ID: I20120416000373 |
Provider Name | Mackenzie Leigh Cucancic |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336891449 PECOS PAC ID: 0749625531 Enrollment ID: I20240304000224 |
Christus Jasper Memorial Hospital Family Practice Center - Jasper Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1276 S Peachtree St, Jasper, TX 75951 Phone: 361-887-9083 | |
Emd Health Centers Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203b S Main St, Jasper, TX 75951 Phone: 409-224-8289 | |