| John K Badlissi Md Pa | |
|
2400 Highway 365 Suite 205 Nederland TX 77627-6249 | |
| (409) 722-1197 | |
| (409) 722-1923 |
| Full Name | John K Badlissi Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2400 Highway 365, Nederland, Texas |
| Authorized Official Name and Position | John K Badlissi (PRESIDENT) |
| Authorized Official Contact | 4097221197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John K Badlissi Md Pa 2400 Highway 365 Suite 205 Nederland TX 77627-6249 Ph: (409) 722-1197 | John K Badlissi Md Pa 2400 Highway 365 Suite 205 Nederland TX 77627-6249 Ph: (409) 722-1197 |
| NPI Number | 1659528032 |
|---|---|
| Provider Enumeration Date | 08/27/2008 |
| Last Update Date | 07/25/2012 |
| Medicare PECOS PAC ID | 0244399806 |
|---|---|
| Medicare Enrollment ID | O20081111000723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659528032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Texas) | Primary |
| Provider Name | John K Badlissi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578753265 PECOS PAC ID: 0345309902 Enrollment ID: I20081111000710 |
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