| Lytle Family Practice Pa | |
|
19432 Davis St Lytle TX 78052-1601 | |
| (830) 709-9960 | |
| Not Available |
| Full Name | Lytle Family Practice Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 19432 Davis St, Lytle, Texas |
| Authorized Official Name and Position | Glendon Saldivar Hack (PRESIDENT) |
| Authorized Official Contact | 8307099960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lytle Family Practice Pa Po Box 324 Von Ormy TX 78073-0324 Ph: (830) 709-9960 | Lytle Family Practice Pa 19432 Davis St Lytle TX 78052-1601 Ph: (830) 709-9960 |
| NPI Number | 1790870327 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0042249070 |
|---|---|
| Medicare Enrollment ID | O20050809001133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790870327 | NPI | - | NPPES |
| 0057NC | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K7753 (Texas) | Primary |
| Provider Name | Glendon S Hack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629073648 PECOS PAC ID: 9537134440 Enrollment ID: I20040901001191 |
Atascosa Health Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19010 Preist Blvd, Lytle, TX 78052 Phone: 830-772-9865 Fax: 830-772-9821 | |
Ops Medical Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 462 Wildflower Dr, Lytle, TX 78052 Phone: 726-800-9802 Fax: 833-505-2044 |