| Ivan N Mefford Md Phd Pa | |
|
1601 Main St Suite 500 Richmond TX 77469-3247 | |
| (281) 342-9500 | |
| (281) 342-6667 |
| Full Name | Ivan N Mefford Md Phd Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1601 Main St, Richmond, Texas |
| Authorized Official Name and Position | Ivan Newton Mefford (OWNER) |
| Authorized Official Contact | 2813429500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivan N Mefford Md Phd Pa 1601 Main St Suite 500 Richmond TX 77469-3247 Ph: (281) 342-9500 | Ivan N Mefford Md Phd Pa 1601 Main St Suite 500 Richmond TX 77469-3247 Ph: (281) 342-9500 |
| NPI Number | 1598858391 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 04/18/2008 |
| Medicare PECOS PAC ID | 4981603883 |
|---|---|
| Medicare Enrollment ID | O20061202000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598858391 | NPI | - | NPPES |
| DF3269 | Other | TX | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K0524 (Texas) | Primary |
| Provider Name | Ivan N Mefford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184672404 PECOS PAC ID: 3870505365 Enrollment ID: I20060627000374 |
| Provider Name | Motaz B Ibrahim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174028039 PECOS PAC ID: 2466855598 Enrollment ID: I20210727000813 |
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