| Matagorda Family Practice, Pllc | |
|
2205 Avenue K Bay City TX 77414-5128 | |
| (979) 323-9752 | |
| (979) 323-9757 |
| Full Name | Matagorda Family Practice, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2205 Avenue K, Bay City, Texas |
| Authorized Official Name and Position | Mohammed Dada (OWNER) |
| Authorized Official Contact | 9793239752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matagorda Family Practice, Pllc Po Box 2660 Bay City TX 77404-2660 Ph: (979) 323-9752 | Matagorda Family Practice, Pllc 2205 Avenue K Bay City TX 77414-5128 Ph: (979) 323-9752 |
| NPI Number | 1962825703 |
|---|---|
| Provider Enumeration Date | 01/30/2014 |
| Last Update Date | 02/01/2022 |
| Medicare PECOS PAC ID | 7618290925 |
|---|---|
| Medicare Enrollment ID | O20141217001821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962825703 | NPI | - | NPPES |
| 361644301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Bruce A Barker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548248461 PECOS PAC ID: 6406741057 Enrollment ID: I20040220000975 |
| Provider Name | Barbara Kay Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598005092 PECOS PAC ID: 4587987813 Enrollment ID: I20150519001826 |
| Provider Name | Shanna Lee Bellamy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508215997 PECOS PAC ID: 9931489499 Enrollment ID: I20161129002784 |
| Provider Name | Belma H Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699380352 PECOS PAC ID: 1850705534 Enrollment ID: I20210121001453 |
| Provider Name | Mckenzie Janak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942958756 PECOS PAC ID: 3173905320 Enrollment ID: I20220804000026 |
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