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345 S Pine St Kountze TX 77625-9329 | |
(409) 246-1014 | |
(409) 246-1029 |
Full Name | |
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Speciality | Family Medicine |
Location | 345 S Pine St, Kountze, Texas |
Authorized Official Name and Position | Jana Marie Winberg (PRESIDENT) |
Authorized Official Contact | 4092461014 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 727 Kountze TX 77625-0727 Ph: (409) 246-1014 | 345 S Pine St Kountze TX 77625-9329 Ph: (409) 246-1014 |
NPI Number | 1285646323 |
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Provider Enumeration Date | 08/13/2006 |
Last Update Date | 07/02/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285646323 | NPI | - | NPPES |
4556334 | Other | TX | CIGNA |
1696619-01 | Medicaid | TX | |
7092365 | Other | TX | AETNA |
0048LX | Other | TX | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | L4815 (Texas) | Primary |