| J. Phillip Myatt, M.d., Pllc | |
|
321 Richland West Cir Waco TX 76712-7919 | |
| (254) 235-9355 | |
| (254) 235-2135 |
| Full Name | J. Phillip Myatt, M.d., Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 321 Richland West Cir, Waco, Texas |
| Authorized Official Name and Position | James Phillip Myatt (OWNER) |
| Authorized Official Contact | 2547155585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Phillip Myatt, M.d., Pllc Po Box 23667 Waco TX 76702-3667 Ph: (254) 235-9355 | J. Phillip Myatt, M.d., Pllc 321 Richland West Cir Waco TX 76712-7919 Ph: (254) 235-9355 |
| NPI Number | 1255674586 |
|---|---|
| Provider Enumeration Date | 04/04/2013 |
| Last Update Date | 02/24/2020 |
| Medicare PECOS PAC ID | 6305089749 |
|---|---|
| Medicare Enrollment ID | O20130904000088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255674586 | NPI | - | NPPES |
| 301250 | Other | TX | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | N1791 (Texas) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | N1791 (Texas) | Primary |
| Provider Name | Jason D Zagrodzky |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1912982018 PECOS PAC ID: 3072509140 Enrollment ID: I20040423000159 |
| Provider Name | Miltiadis Leon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558328690 PECOS PAC ID: 7113900150 Enrollment ID: I20040610000624 |
| Provider Name | Brian Walton |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770567976 PECOS PAC ID: 3971581075 Enrollment ID: I20040713001116 |
| Provider Name | Ronda L Mullenax |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285962688 PECOS PAC ID: 7911167887 Enrollment ID: I20120330000047 |
| Provider Name | Abdul M Keylani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386692689 PECOS PAC ID: 5890755433 Enrollment ID: I20120814000289 |
| Provider Name | James Phillip Myatt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871778001 PECOS PAC ID: 1951433176 Enrollment ID: I20130904000114 |
| Provider Name | Nicole L Reid |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215089891 PECOS PAC ID: 9436193174 Enrollment ID: I20130917000539 |
| Provider Name | Jeremiah Havins |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1427217009 PECOS PAC ID: 7416261334 Enrollment ID: I20150805007066 |
| Provider Name | Daniel Jipescu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134573637 PECOS PAC ID: 0042666364 Enrollment ID: I20231023003576 |
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