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4534 W Gate Blvd Suite113 Austin TX 78745-1485 | |
(512) 394-6020 | |
(512) 350-2825 |
Full Name | |
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Speciality | Family Medicine |
Location | 4534 W Gate Blvd, Austin, Texas |
Authorized Official Name and Position | Gregory Marchand (PRESIDENT) |
Authorized Official Contact | 5123946020 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4534 W Gate Blvd Suite113 Austin TX 78745-1485 Ph: (512) 394-6020 | 4534 W Gate Blvd Suite113 Austin TX 78745-1485 Ph: (512) 394-6020 |
NPI Number | 1861804965 |
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Provider Enumeration Date | 05/22/2014 |
Last Update Date | 07/02/2015 |
Medicare PECOS PAC ID | 5092932160 |
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Medicare Enrollment ID | O20140813001725 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861804965 | NPI | - | NPPES |
8983B9 | Other | TX | MEDICARE INDIVIDUAL |
G8620 | Other | TX | TEXAS MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | G8620 (Texas) | Primary |
Provider Name | Nathan A Graves |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992705768 PECOS PAC ID: 3779502158 Enrollment ID: I20051115000487 |
Provider Name | Daniel L Rasor |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1043211329 PECOS PAC ID: 5294880068 Enrollment ID: I20090831000240 |
Provider Name | Gregory Marchand |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033104336 PECOS PAC ID: 9335151349 Enrollment ID: I20100728000593 |
Harold D Lewis Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 West William Cannon Drive, Suite 123, Austin, TX 78745 Phone: 512-444-2661 Fax: 512-444-2720 | |
Julie Graves Moy Md Mph Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8127 Mesa Dr, B206-54, Austin, TX 78759 Phone: 512-689-8001 | |
Edie E. Shulman M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11673 Jollyville Rd., Suite B-101, Austin, TX 78759 Phone: 512-339-1535 Fax: 512-339-1526 | |
Doctx3 Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 W Slaughter Ln, Suite 300, Austin, TX 78748 Phone: 469-277-8253 |