| Nacogdoches Family Practice, Pa | |
|
1023 N Mound St Suite A Nacogdoches TX 75961-4491 | |
| (936) 564-2691 | |
| (936) 560-5224 |
| Full Name | Nacogdoches Family Practice, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1023 N Mound St, Nacogdoches, Texas |
| Authorized Official Name and Position | Edwin Emborgo (OWNER) |
| Authorized Official Contact | 9365642691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nacogdoches Family Practice, Pa Po Box 630696 Nacogdoches TX 75963 Ph: (936) 553-2534 | Nacogdoches Family Practice, Pa 1023 N Mound St Suite A Nacogdoches TX 75961-4491 Ph: (936) 564-2691 |
| NPI Number | 1235317082 |
|---|---|
| Provider Enumeration Date | 02/04/2008 |
| Last Update Date | 06/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235317082 | NPI | - | NPPES |
| M8458 | Other | TX | TEXAS MEDICAL LICENSE |
| 203713701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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