| Lakepointe Direct Primary Care | |
|
713 Hebron Pkwy Ste 220 Lewisville TX 75057-5135 | |
| (972) 315-8588 | |
| Not Available |
| Full Name | Lakepointe Direct Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 713 Hebron Pkwy Ste 220, Lewisville, Texas |
| Authorized Official Name and Position | Marcelo Ernesto Brito Telles (MEDICAL DIRECTOR/FAMILY PHYSICIAN) |
| Authorized Official Contact | 7797707011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakepointe Direct Primary Care 2812 Dorset The Colony TX 75056-3592 Ph: (779) 770-7011 | Lakepointe Direct Primary Care 713 Hebron Pkwy Ste 220 Lewisville TX 75057-5135 Ph: (972) 315-8588 |
| NPI Number | 1285394015 |
|---|---|
| Provider Enumeration Date | 12/21/2021 |
| Last Update Date | 10/13/2022 |
| Medicare PECOS PAC ID | 1557738747 |
|---|---|
| Medicare Enrollment ID | O20221101000014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285394015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marcelo Ernesto Brito Telles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699062018 PECOS PAC ID: 3476793563 Enrollment ID: I20151102001542 |
| Provider Name | Sonya Aileena Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215647706 PECOS PAC ID: 2264806140 Enrollment ID: I20230315002055 |
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