| Medina Valley Family Practice | |
|
409 Madrid St Castroville TX 78009-4527 | |
| (830) 538-2254 | |
| (830) 931-2259 |
| Full Name | Medina Valley Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 409 Madrid St, Castroville, Texas |
| Authorized Official Name and Position | Lloyd P Vanwinkle (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8305382254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medina Valley Family Practice 409 Madrid St Castroville TX 78009-4527 Ph: (830) 538-2254 | Medina Valley Family Practice 409 Madrid St Castroville TX 78009-4527 Ph: (830) 538-2254 |
| NPI Number | 1992837330 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 10/16/2024 |
| Medicare PECOS PAC ID | 5294040952 |
|---|---|
| Medicare Enrollment ID | O20150811003781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992837330 | NPI | - | NPPES |
| 142464002 | Medicaid | TX | |
| 45D0498955 | Other | TX | CLIA |
| TXB104619 | Other | TX | MEDICARE ID TYPE UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | G3878 (Texas) | Primary |
| Provider Name | Lloyd P Van Winkle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306833173 PECOS PAC ID: 0345150934 Enrollment ID: I20060726000285 |
| Provider Name | Mary S Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356339717 PECOS PAC ID: 1557485679 Enrollment ID: I20100826000415 |
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