Myrna C De Asis Md Pa | |
1819 Tenth St Wichita Falls TX 76301-5012 | |
(940) 763-8077 | |
Not Available |
Full Name | Myrna C De Asis Md Pa |
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Speciality | Internal Medicine |
Location | 1819 Tenth St, Wichita Falls, Texas |
Authorized Official Name and Position | Oscar Desnacido De Asis (VICE-PRESIDENT, OFFICE MANAGER) |
Authorized Official Contact | 9407638077 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Myrna C De Asis Md Pa Po Box 4710 Wichita Falls TX 76308 Ph: (940) 763-8077 | Myrna C De Asis Md Pa 1819 Tenth St Wichita Falls TX 76301-5012 Ph: (940) 763-8077 |
NPI Number | 1952496929 |
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Provider Enumeration Date | 10/04/2006 |
Last Update Date | 09/01/2010 |
Medicare PECOS PAC ID | 4183748353 |
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Medicare Enrollment ID | O20100825000988 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952496929 | NPI | - | NPPES |
164418901 | Medicaid | TX | |
45D0942509 | Other | TX | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | K4405 (Texas) | Primary |
Provider Name | Myrna Catalan De Asis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043214406 PECOS PAC ID: 5092839266 Enrollment ID: I20100902000971 |
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