John P Lavery Md Pa | |
997 Raintree Cir Ste 120 Allen TX 75013-4951 | |
(972) 747-0709 | |
(972) 747-7991 |
Full Name | John P Lavery Md Pa |
---|---|
Speciality | Family Medicine |
Location | 997 Raintree Cir Ste 120, Allen, Texas |
Authorized Official Name and Position | John Patrick Lavery (DIRECTOR) |
Authorized Official Contact | 9727470709 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
John P Lavery Md Pa 997 Raintree Cir Ste 120 Allen TX 75013-4951 Ph: (972) 747-0709 | John P Lavery Md Pa 997 Raintree Cir Ste 120 Allen TX 75013-4951 Ph: (972) 747-0709 |
NPI Number | 1952530958 |
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Provider Enumeration Date | 07/10/2009 |
Last Update Date | 06/13/2014 |
Medicare PECOS PAC ID | 3870632052 |
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Medicare Enrollment ID | O20091201000328 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952530958 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | H7453 (Texas) | Primary |
Provider Name | John Lavery |
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Provider Type | Practitioner - Rheumatology |
Provider Identifiers | NPI Number: 1740239227 PECOS PAC ID: 0749204055 Enrollment ID: I20091116000245 |
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