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1016 N 17th St Lamesa TX 79331-2404 | |
(806) 872-5727 | |
(806) 872-0823 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 1016 N 17th St, Lamesa, Texas |
Authorized Official Name and Position | Jeffrey Edward Weaver (CFO) |
Authorized Official Contact | 8068725727 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2200 N Bryan Ave Lamesa TX 79331-2451 Ph: (086) 872-5727 | 1016 N 17th St Lamesa TX 79331-2404 Ph: (806) 872-5727 |
NPI Number | 1730570920 |
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Provider Enumeration Date | 02/10/2015 |
Last Update Date | 02/11/2015 |
Identifier | Type | State | Issuer |
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1730570920 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Griengsak Chowpaknam Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 N Bryan Ave, Lamesa, TX 79331 Phone: 806-796-0507 Fax: 806-799-6908 | |