| Pasadena Ppm, Llc | |
|
3350 Fairview St. Pasadena TX 77504-1904 | |
| (713) 944-9830 | |
| (713) 944-6116 |
| Full Name | Pasadena Ppm, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3350 Fairview St., Pasadena, Texas |
| Authorized Official Name and Position | Rick A Boyles (MANAGING MEMBER) |
| Authorized Official Contact | 7139440189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pasadena Ppm, Llc 3350 Fairview St. Pasadena TX 77504-1904 Ph: (713) 944-0189 | Pasadena Ppm, Llc 3350 Fairview St. Pasadena TX 77504-1904 Ph: (713) 944-9830 |
| NPI Number | 1245684596 |
|---|---|
| Provider Enumeration Date | 04/22/2016 |
| Last Update Date | 03/16/2023 |
| Medicare PECOS PAC ID | 8426341793 |
|---|---|
| Medicare Enrollment ID | O20160725000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245684596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ricky A Boyles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356537799 PECOS PAC ID: 9234291188 Enrollment ID: I20081231000153 |
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