| Medical Center West | |
|
1201 S Main St Ste 110 Boerne TX 78006-2833 | |
| (830) 249-6000 | |
| (830) 816-6002 |
| Full Name | Medical Center West |
|---|---|
| Speciality | Clinic/Center |
| Location | 1201 S Main St, Boerne, Texas |
| Authorized Official Name and Position | Michelle D Berry (PHYSICIAN) |
| Authorized Official Contact | 8302496000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center West Po Box 339 Boerne TX 78006-0339 Ph: (830) 249-6000 | Medical Center West 1201 S Main St Ste 110 Boerne TX 78006-2833 Ph: (830) 249-6000 |
| NPI Number | 1396900528 |
|---|---|
| Provider Enumeration Date | 07/28/2008 |
| Last Update Date | 05/29/2012 |
| Medicare PECOS PAC ID | 2062560972 |
|---|---|
| Medicare Enrollment ID | O20090504000346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396900528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | H9798 (Texas) | Primary |
| Provider Name | Michelle Berry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033194527 PECOS PAC ID: 6608787304 Enrollment ID: I20090504000314 |
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