| Ldrmc Profession Services | |
|
1353 N Travis Liberty TX 77575-3549 | |
| (936) 336-7316 | |
| (936) 336-2862 |
| Full Name | Ldrmc Profession Services |
|---|---|
| Speciality | Family Medicine |
| Location | 1353 N Travis, Liberty, Texas |
| Authorized Official Name and Position | Rhonda Campbell (CEO) |
| Authorized Official Contact | 9363367316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ldrmc Profession Services 1353 N Travis Liberty TX 77575-3549 Ph: (936) 336-7316 | Ldrmc Profession Services 1353 N Travis Liberty TX 77575-3549 Ph: (936) 336-7316 |
| NPI Number | 1528367356 |
|---|---|
| Provider Enumeration Date | 03/18/2011 |
| Last Update Date | 09/26/2024 |
| Medicare PECOS PAC ID | 3678766227 |
|---|---|
| Medicare Enrollment ID | O20160919002678 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528367356 | NPI | - | NPPES |
| Provider Name | Dale W Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922055292 PECOS PAC ID: 2860390614 Enrollment ID: I20031230000720 |
| Provider Name | Russell W Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083702948 PECOS PAC ID: 8921057415 Enrollment ID: I20050122000029 |
| Provider Name | Amanuel M Abreha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821059841 PECOS PAC ID: 8325084320 Enrollment ID: I20060224000664 |
| Provider Name | Nitin Mahajan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467561902 PECOS PAC ID: 5395743470 Enrollment ID: I20140909000213 |
| Provider Name | David Chiao |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1336431352 PECOS PAC ID: 0648408161 Enrollment ID: I20170711000327 |
| Provider Name | Heather Emmitte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114698644 PECOS PAC ID: 5597156166 Enrollment ID: I20211216000215 |
| Provider Name | Andrea Noelle Miller |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346500402 PECOS PAC ID: 3870987571 Enrollment ID: I20220223000515 |
| Provider Name | Eddie Truelove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023042298 PECOS PAC ID: 5799708871 Enrollment ID: I20221118000865 |
| Provider Name | Victoria Dianne Manning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053033530 PECOS PAC ID: 9032588660 Enrollment ID: I20221203000100 |
| Provider Name | Jillian B Heenan-maginness |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932757598 PECOS PAC ID: 3173906807 Enrollment ID: I20230116000939 |
| Provider Name | Charla Stagg Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831218650 PECOS PAC ID: 8628434198 Enrollment ID: I20230525002794 |
| Provider Name | Kayla Ash Sheffield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336888783 PECOS PAC ID: 8022472695 Enrollment ID: I20230914003148 |
| Provider Name | William Garrett Ransom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790498251 PECOS PAC ID: 4486027703 Enrollment ID: I20231111000601 |
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Firm Foundations Healthcare Clinic Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2708 Jefferson Dr Ste A, Liberty, TX 77575 Phone: 936-334-8800 Fax: 936-334-8801 | |
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