| Jasper Diagnostic Clinic | |
|
300 Marvin Hancock Dr Jasper TX 75951-3480 | |
| (409) 383-1355 | |
| (409) 384-7276 |
| Full Name | Jasper Diagnostic Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 Marvin Hancock Dr, Jasper, Texas |
| Authorized Official Name and Position | Saurabh Singh (OWNER) |
| Authorized Official Contact | 4093831355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jasper Diagnostic Clinic 300 Marvin Hancock Dr Jasper TX 75951-3480 Ph: (409) 383-1355 | Jasper Diagnostic Clinic 300 Marvin Hancock Dr Jasper TX 75951-3480 Ph: (409) 383-1355 |
| NPI Number | 1801075957 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 10/25/2007 |
| Medicare PECOS PAC ID | 1759354384 |
|---|---|
| Medicare Enrollment ID | O20040812001461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801075957 | NPI | - | NPPES |
| 1442428 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | J4671 (Texas) | Primary |
| Provider Name | Saurabh Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871593103 PECOS PAC ID: 1557334182 Enrollment ID: I20100208000807 |
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