| Lawndale Medical Clinic | |
|
7109 Lawndale St Suite B Houston TX 77023-4248 | |
| (832) 200-1646 | |
| (832) 200-1660 |
| Full Name | Lawndale Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 7109 Lawndale St, Houston, Texas |
| Authorized Official Name and Position | Calixto Jorge Ruibal (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8322001646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawndale Medical Clinic 7109 Lawndale St Suite B Houston TX 77023-4248 Ph: (832) 200-1646 | Lawndale Medical Clinic 7109 Lawndale St Suite B Houston TX 77023-4248 Ph: (832) 200-1646 |
| NPI Number | 1518012558 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 01/12/2011 |
| Medicare PECOS PAC ID | 6608834965 |
|---|---|
| Medicare Enrollment ID | O20050103000995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518012558 | NPI | - | NPPES |
| 085095001 | Medicaid | TX |
| Provider Name | Julio Fernando Scaglia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205931029 PECOS PAC ID: 3577520329 Enrollment ID: I20050103000729 |
| Provider Name | Calixto J Ruibal |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730284555 PECOS PAC ID: 6507883428 Enrollment ID: I20100104000501 |
| Provider Name | Bernardine Amadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487885901 PECOS PAC ID: 1850421280 Enrollment ID: I20100611000297 |
| Provider Name | Silvia Boccardo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861480204 PECOS PAC ID: 1052418050 Enrollment ID: I20101117001381 |
| Provider Name | Manuel Corcho Alonso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710552971 PECOS PAC ID: 9335541192 Enrollment ID: I20210823002786 |
| Provider Name | Yosel Santiesteban Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609491059 PECOS PAC ID: 8022497569 Enrollment ID: I20220614000950 |
| Provider Name | Madelaine Bidondo Gil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588433882 PECOS PAC ID: 9739524497 Enrollment ID: I20240304002903 |
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