| Med Plaza | |
|
703 E Marshall Ave Suite 310 Longview TX 75601-5500 | |
| (603) 234-8611 | |
| (903) 758-2283 |
| Full Name | Med Plaza |
|---|---|
| Speciality | Clinic/Center |
| Location | 703 E Marshall Ave, Longview, Texas |
| Authorized Official Name and Position | Kim Nesvig (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9032340776 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Med Plaza Po Box 2709 Longview TX 75606-2709 Ph: (903) 234-0776 | Med Plaza 703 E Marshall Ave Suite 310 Longview TX 75601-5500 Ph: (603) 234-8611 |
| NPI Number | 1750769238 |
|---|---|
| Provider Enumeration Date | 05/15/2015 |
| Last Update Date | 01/20/2023 |
| Medicare PECOS PAC ID | 1355326158 |
|---|---|
| Medicare Enrollment ID | O20150908001240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750769238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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