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2007 N Jefferson Ave Mount Pleasant TX 75455-2336 | |
(903) 572-6655 | |
(903) 572-0213 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2007 N Jefferson Ave, Mount Pleasant, Texas |
Authorized Official Name and Position | Christian Elliston (CEO) |
Authorized Official Contact | 7202737449 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3900 E Mexico Ave Ste 102 Denver CO 80210-3941 Ph: (303) 800-2078 | 2007 N Jefferson Ave Mount Pleasant TX 75455-2336 Ph: (903) 572-6655 |
NPI Number | 1457334039 |
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Provider Enumeration Date | 11/28/2005 |
Last Update Date | 08/20/2020 |
Medicare PECOS PAC ID | 9931287232 |
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Medicare Enrollment ID | O20080428000501 |
Identifier | Type | State | Issuer |
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1457334039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Mark J Glanzer |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1336121003 PECOS PAC ID: 2062554413 Enrollment ID: I20100122000330 |
Provider Name | Michael A Minadeo |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1356323489 PECOS PAC ID: 6103904404 Enrollment ID: I20120321000219 |
Provider Name | Sai H Chavala |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1548391311 PECOS PAC ID: 2860583499 Enrollment ID: I20150223001442 |
Provider Name | Moulaye Ahmed Haidara |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1942647722 PECOS PAC ID: 4486952694 Enrollment ID: I20180830002152 |