| |
1353 N Travis Liberty TX 77575-3549 | |
(936) 336-7316 | |
(936) 336-2862 |
Full Name | |
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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 |
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1353 N Travis Liberty TX 77575-3549 Ph: (936) 336-7316 | 1353 N Travis Liberty TX 77575-3549 Ph: (936) 336-7316 |
NPI Number | 1528367356 |
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Provider Enumeration Date | 03/18/2011 |
Last Update Date | 09/26/2024 |
Medicare PECOS PAC ID | 3678766227 |
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Medicare Enrollment ID | O20160919002678 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528367356 | NPI | - | NPPES |
Provider Name | Dale W Brock |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922055292 PECOS PAC ID: 2860390614 Enrollment ID: I20031230000720 |
Provider Name | Amanuel M Abreha |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821059841 PECOS PAC ID: 8325084320 Enrollment ID: I20060224000664 |
Provider Name | Mark R Boyle |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1861519274 PECOS PAC ID: 3072614676 Enrollment ID: I20070726000574 |
Provider Name | Mark A Wilson |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1679660682 PECOS PAC ID: 2163526229 Enrollment ID: I20081203000452 |
Provider Name | Daniel Jin Young Kim |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1063642122 PECOS PAC ID: 3870760630 Enrollment ID: I20120118000752 |
Provider Name | Lindsay F Dragos |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1164713772 PECOS PAC ID: 2466694625 Enrollment ID: I20130819000096 |
Provider Name | Brett A Burnett |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1871813402 PECOS PAC ID: 9739323908 Enrollment ID: I20130910000778 |
Provider Name | Nitin Mahajan |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1467561902 PECOS PAC ID: 5395743470 Enrollment ID: I20140909000213 |
Provider Name | Nicole E Malouf |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1699096966 PECOS PAC ID: 9436399979 Enrollment ID: I20141014001206 |
Provider Name | Denzil K Frost |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1801187596 PECOS PAC ID: 4688995715 Enrollment ID: I20150602000749 |
Provider Name | Joseph Eugene Bales |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1700142387 PECOS PAC ID: 7517198930 Enrollment ID: I20150603000568 |
Provider Name | David Chiao |
---|---|
Provider Type | Practitioner - Interventional Radiology |
Provider Identifiers | NPI Number: 1336431352 PECOS PAC ID: 0648408161 Enrollment ID: I20170711000327 |
Provider Name | Daniel S Frank |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1730506007 PECOS PAC ID: 4486924206 Enrollment ID: I20170726002828 |
Provider Name | Stace K Breland |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1821417155 PECOS PAC ID: 6305116187 Enrollment ID: I20170727000811 |
Provider Name | Gregory Taroyan |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1114337540 PECOS PAC ID: 0547540106 Enrollment ID: I20171002003374 |
Provider Name | Meredith Gault Brown |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1639306574 PECOS PAC ID: 0648429001 Enrollment ID: I20171024000097 |
Provider Name | Nashid Shinthia |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1114376167 PECOS PAC ID: 2668763053 Enrollment ID: I20190816001581 |
Provider Name | Andrea Noelle Miller |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1346500402 PECOS PAC ID: 3870987571 Enrollment ID: I20220223000515 |
Provider Name | Syrila D Bossert |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902348956 PECOS PAC ID: 9335429802 Enrollment ID: I20221005002232 |
Provider Name | Victoria Dianne Manning |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053033530 PECOS PAC ID: 9032588660 Enrollment ID: I20221203000100 |
Provider Name | Patrick J Asay |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1932724630 PECOS PAC ID: 4284006867 Enrollment ID: I20230207003578 |
Provider Name | Charla Stagg Reid |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831218650 PECOS PAC ID: 8628434198 Enrollment ID: I20230525002794 |
Provider Name | John F Trentini |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1891037347 PECOS PAC ID: 3678703568 Enrollment ID: I20240618002032 |
Provider Name | Jenny L Glenn |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164180485 PECOS PAC ID: 5496290074 Enrollment ID: I20240709000893 |
Firm Foundations Healthcare Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2708 Jefferson Dr, Ste A, Liberty, TX 77575 Phone: 936-334-8800 Fax: 936-334-8801 | |
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 | |
Astros Healthcare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 723 Main St, Liberty, TX 77575 Phone: 832-331-8438 Fax: 281-873-8101 | |