| Milton W. Shepperd, Do, Pa | |
|
113 Broadmoor St Meadowlakes TX 78654-6601 | |
| (830) 693-1792 | |
| (830) 693-1685 |
| Full Name | Milton W. Shepperd, Do, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 113 Broadmoor St, Meadowlakes, Texas |
| Authorized Official Name and Position | Milton Wirtz Shepperd (PRESIDENT) |
| Authorized Official Contact | 8306931792 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milton W. Shepperd, Do, Pa Po Box 1930 Marble Falls TX 78654-2680 Ph: (830) 693-1792 | Milton W. Shepperd, Do, Pa 113 Broadmoor St Meadowlakes TX 78654-6601 Ph: (830) 693-1792 |
| NPI Number | 1629149810 |
|---|---|
| Provider Enumeration Date | 11/11/2006 |
| Last Update Date | 05/05/2009 |
| Medicare PECOS PAC ID | 0547292583 |
|---|---|
| Medicare Enrollment ID | O20050909000870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629149810 | NPI | - | NPPES |
| 176966302 | Medicaid | TX | |
| 176966301 | Medicaid | TX | |
| DG9173 | Other | TX | RAILROAD MEDICARE |
| 0068AA | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | J6722 (Texas) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | J6722 (Texas) | Primary |
| Provider Name | Milton W Shepperd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801967096 PECOS PAC ID: 7517997430 Enrollment ID: I20050819000258 |
| Provider Name | Mary E Eilers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578763900 PECOS PAC ID: 8426148388 Enrollment ID: I20071214000546 |
| Provider Name | Camile Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427213560 PECOS PAC ID: 4183785157 Enrollment ID: I20081209000509 |
Milton W Shepperd, Do, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Broadmoor St, Meadowlakes, TX 78654 Phone: 830-693-1792 Fax: 830-693-1685 |