Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 101 Anthony Drive, Teague, Texas |
Authorized Official Name and Position | Sharlee Lebleu (SR. DIRECTOR PROVIDER ENROLLMENT) |
Authorized Official Contact | 6159207192 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 38 Teague TX 75860-0038 Ph: (254) 739-5655 | 101 Anthony Drive Teague TX 75860 Ph: (254) 739-5655 |
NPI Number | 1346638236 |
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Provider Enumeration Date | 12/31/2014 |
Last Update Date | 02/18/2019 |
Medicare PECOS PAC ID | 8921911876 |
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Medicare Enrollment ID | O20150415001077 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346638236 | NPI | - | NPPES |
Cornerstone Family Care Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 236 E Loop 255, Teague, TX 75860 Phone: 254-739-5090 Fax: 254-739-5666 | |