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411 East Jefferson St Waxahachie TX 75165 | |
| (972) 923-2440 | |
| (972) 923-2445 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 411 East Jefferson St, Waxahachie, Texas |
| Authorized Official Name and Position | Kathleen Marshall (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9729232440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
411 East Jefferson St Waxahachie TX 75165 Ph: (972) 923-2440 | 411 East Jefferson St Waxahachie TX 75165 Ph: (972) 923-2440 |
| NPI Number | 1326236464 |
|---|---|
| Provider Enumeration Date | 10/12/2007 |
| Last Update Date | 10/23/2024 |
| Medicare PECOS PAC ID | 2365500261 |
|---|---|
| Medicare Enrollment ID | O20081022000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326236464 | NPI | - | NPPES |
| 2083164-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Texas) | Primary |
| Provider Name | Brandee L Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407851991 PECOS PAC ID: 8820050438 Enrollment ID: I20041027000178 |
| Provider Name | Kimberly Karla Sweet |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366487159 PECOS PAC ID: 2961441084 Enrollment ID: I20050428000333 |
| Provider Name | James Yarmchuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467475582 PECOS PAC ID: 3375575970 Enrollment ID: I20050902000662 |
| Provider Name | Sandra B Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457631764 PECOS PAC ID: 7810161130 Enrollment ID: I20111123000570 |
| Provider Name | Frances D Casanova |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407137490 PECOS PAC ID: 9032379920 Enrollment ID: I20120330000273 |
| Provider Name | Michael A Meyerson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770516494 PECOS PAC ID: 6103061106 Enrollment ID: I20130322000018 |
| Provider Name | Carla Z Marchesi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023358744 PECOS PAC ID: 9739327941 Enrollment ID: I20130530000052 |
| Provider Name | Candice R Winful |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386842771 PECOS PAC ID: 4284781386 Enrollment ID: I20130829000820 |
| Provider Name | Mary E Sorial |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427322585 PECOS PAC ID: 1153633854 Enrollment ID: I20150709001118 |
| Provider Name | Denise Jeffries |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922423953 PECOS PAC ID: 4082837836 Enrollment ID: I20151114000089 |
| Provider Name | Ebenezer A Nii-moi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396930376 PECOS PAC ID: 9931299062 Enrollment ID: I20161205000792 |
| Provider Name | Ann Marie Haney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124549373 PECOS PAC ID: 2668748617 Enrollment ID: I20171019001303 |
| Provider Name | Christine Vera Varela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811400047 PECOS PAC ID: 2365797669 Enrollment ID: I20180608000908 |
| Provider Name | Taylor L Fiorenza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568001865 PECOS PAC ID: 1951719863 Enrollment ID: I20210414000832 |
| Provider Name | Ugbodu Awoniyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174147037 PECOS PAC ID: 7315355914 Enrollment ID: I20210420002499 |
| Provider Name | Diane M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427467422 PECOS PAC ID: 7618197815 Enrollment ID: I20210813002688 |
| Provider Name | Emily G Durbin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982295754 PECOS PAC ID: 4284038175 Enrollment ID: I20210816000743 |
| Provider Name | Lisa Jenney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184270035 PECOS PAC ID: 3375975485 Enrollment ID: I20220304001000 |
| Provider Name | Ernie S Hartley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285341446 PECOS PAC ID: 9234508821 Enrollment ID: I20221202000955 |
| Provider Name | Bernice Aderintola Bamgbade |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609496637 PECOS PAC ID: 3779969100 Enrollment ID: I20240109001345 |
| Provider Name | Sandra Kirby Bruce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669962015 PECOS PAC ID: 6800234105 Enrollment ID: I20240405001073 |
| Provider Name | Tamara Wobig Mcqueary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902320765 PECOS PAC ID: 8628511029 Enrollment ID: I20240613001739 |
| Provider Name | Rachel Werling |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1194357350 PECOS PAC ID: 9335524198 Enrollment ID: I20240721000083 |
Complete Health Medical Center Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Ferris Ave, Waxahachie, TX 75165 Phone: 972-937-0086 Fax: 972-923-2351 | |
Advantage Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1102 Solon Place Way, Suite 1, Waxahachie, TX 75165 Phone: 972-351-9993 Fax: 972-351-9984 | |
Kare Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 S. Grand Suite #2, Waxahachie, TX 75165 Phone: 972-938-0100 Fax: 972-937-9073 | |
Trinity Health Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 507 N Highway 77 Ste 902, Waxahachie, TX 75165 Phone: 469-296-9909 | |