| Iwc Of Texas Llc | |
|
315 N Shary Rd Ste 1014 Mission TX 78572-8235 | |
| (956) 205-2800 | |
| (956) 205-2427 |
| Full Name | Iwc Of Texas Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 315 N Shary Rd Ste 1014, Mission, Texas |
| Authorized Official Name and Position | Charles Dappen (PRESIDENT) |
| Authorized Official Contact | 9562052800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iwc Of Texas Llc 315 N Shary Rd Ste 1014 Mission TX 78572-8235 Ph: (956) 205-2800 | Iwc Of Texas Llc 315 N Shary Rd Ste 1014 Mission TX 78572-8235 Ph: (956) 205-2800 |
| NPI Number | 1740024454 |
|---|---|
| Provider Enumeration Date | 06/19/2024 |
| Last Update Date | 06/19/2024 |
| Medicare PECOS PAC ID | 4587102033 |
|---|---|
| Medicare Enrollment ID | O20240814004064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740024454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Miguel A Molinas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841389087 PECOS PAC ID: 5799828646 Enrollment ID: I20100201000743 |
| Provider Name | Gerard Achilles M Obnial |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427692144 PECOS PAC ID: 4880020247 Enrollment ID: I20200203000723 |
| Provider Name | Vincent Rebugio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194250928 PECOS PAC ID: 1355747577 Enrollment ID: I20210913002922 |
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