| Pak Medical Group | |
|
1762 E Common St New Braunfels TX 78130-6059 | |
| (830) 730-8580 | |
| (830) 327-1021 |
| Full Name | Pak Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 1762 E Common St, New Braunfels, Texas |
| Authorized Official Name and Position | Veronica Jean Harlan (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8307305025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pak Medical Group 425 W Colonial Dr Ste 303 Orlando FL 32804-6863 Ph: (321) 343-6833 | Pak Medical Group 1762 E Common St New Braunfels TX 78130-6059 Ph: (830) 730-8580 |
| NPI Number | 1992297816 |
|---|---|
| Provider Enumeration Date | 06/06/2018 |
| Last Update Date | 10/18/2024 |
| Medicare PECOS PAC ID | 4486904315 |
|---|---|
| Medicare Enrollment ID | O20180913002148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992297816 | NPI | - | NPPES |
| 3947798-01 | Medicaid | TX | |
| 3947798-02 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Filomeno P Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376549204 PECOS PAC ID: 9133019748 Enrollment ID: I20050914000195 |
| Provider Name | Ho Sung Sung Pak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518025766 PECOS PAC ID: 1759313794 Enrollment ID: I20050915000404 |
| Provider Name | Arindam Bandyopadhyay |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407843972 PECOS PAC ID: 4981624855 Enrollment ID: I20051207000197 |
| Provider Name | James Ray Bartay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518055581 PECOS PAC ID: 0345372041 Enrollment ID: I20100715000654 |
| Provider Name | Anne Shackelford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366779134 PECOS PAC ID: 2163546987 Enrollment ID: I20100901000082 |
| Provider Name | Sankararao Tamtam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588625735 PECOS PAC ID: 8820285745 Enrollment ID: I20101203001202 |
| Provider Name | Christopher Wofford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427195171 PECOS PAC ID: 5294995940 Enrollment ID: I20120404000565 |
| Provider Name | Erin L Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477746121 PECOS PAC ID: 3971769027 Enrollment ID: I20120718000515 |
| Provider Name | Anthony C Bienek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336376995 PECOS PAC ID: 8820233356 Enrollment ID: I20130403000434 |
| Provider Name | Clay T Buchanan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578900486 PECOS PAC ID: 7315259595 Enrollment ID: I20150630002303 |
| Provider Name | Gwendolyn M Hendricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891225934 PECOS PAC ID: 2466722202 Enrollment ID: I20170726003415 |
| Provider Name | John E Stanhope |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740331016 PECOS PAC ID: 4486790748 Enrollment ID: I20170823003396 |
| Provider Name | Jeremy Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184892622 PECOS PAC ID: 6002116324 Enrollment ID: I20180201001380 |
| Provider Name | Kimberly Catlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922388727 PECOS PAC ID: 6608035092 Enrollment ID: I20180419002675 |
| Provider Name | Michelle R Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184081747 PECOS PAC ID: 4486999117 Enrollment ID: I20181227000503 |
| Provider Name | Mallory Antoinette Jacobs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124406475 PECOS PAC ID: 1456786193 Enrollment ID: I20200127001489 |
| Provider Name | William Vance Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841796562 PECOS PAC ID: 7618306895 Enrollment ID: I20200409001997 |
| Provider Name | Maria Salinas |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1043530207 PECOS PAC ID: 0840517504 Enrollment ID: I20211117001033 |
| Provider Name | Ryan Andrew Armour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003080557 PECOS PAC ID: 6800051269 Enrollment ID: I20220405003220 |
| Provider Name | Ashley M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063194009 PECOS PAC ID: 1759737919 Enrollment ID: I20231024001779 |
| Provider Name | Nora Saul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801132014 PECOS PAC ID: 6709030521 Enrollment ID: I20231031002478 |
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