| Pecos County Memorial Hospital | |
|
387 West Ih 10 Fort Stockton TX 79735-2700 | |
| (432) 336-2058 | |
| (844) 824-3604 |
| Full Name | Pecos County Memorial Hospital |
|---|---|
| Speciality | Family Medicine |
| Location | 387 West Ih 10, Fort Stockton, Texas |
| Authorized Official Name and Position | Melissa Pena (DIRECTOR) |
| Authorized Official Contact | 4323364880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pecos County Memorial Hospital 387 West Ih 10 Fort Stockton TX 79735-2700 Ph: (432) 336-2058 | Pecos County Memorial Hospital 387 West Ih 10 Fort Stockton TX 79735-2700 Ph: (432) 336-2058 |
| NPI Number | 1457307175 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 11/08/2019 |
| Medicare PECOS PAC ID | 0446160733 |
|---|---|
| Medicare Enrollment ID | O20041122000269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457307175 | NPI | - | NPPES |
| 0079AE | Other | TX | BCBS GROUP NUMBER |
| 091939102 | Medicaid | TX | |
| 091939103 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| Provider Name | Michael D Parker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417177825 PECOS PAC ID: 1153386966 Enrollment ID: I20041122000245 |
| Provider Name | Cecil R George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467427435 PECOS PAC ID: 4082678974 Enrollment ID: I20080820000032 |
| Provider Name | Auden C Velasquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740430230 PECOS PAC ID: 8123168861 Enrollment ID: I20091210000557 |
| Provider Name | Scott C Emerick |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548240427 PECOS PAC ID: 8022092337 Enrollment ID: I20091214000246 |
| Provider Name | Genaro H Marquez |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689952582 PECOS PAC ID: 5092987636 Enrollment ID: I20111004000518 |
| Provider Name | Rahul Boinpally |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891920997 PECOS PAC ID: 3476707035 Enrollment ID: I20130206000535 |
| Provider Name | Daniel B Howell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881934180 PECOS PAC ID: 1658519210 Enrollment ID: I20130521000677 |
| Provider Name | Laura Gesick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295164929 PECOS PAC ID: 7719117399 Enrollment ID: I20140226001854 |
| Provider Name | Suhail Sami Daye |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639251481 PECOS PAC ID: 2961685409 Enrollment ID: I20140806001037 |
| Provider Name | Rachelle Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003255399 PECOS PAC ID: 7113245523 Enrollment ID: I20150415001665 |
| Provider Name | Jodi Zuber |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437515145 PECOS PAC ID: 2961705652 Enrollment ID: I20160130000018 |
| Provider Name | Pamela J Gougler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053757104 PECOS PAC ID: 0749570828 Enrollment ID: I20170124001718 |
| Provider Name | Samuel Itie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952794687 PECOS PAC ID: 4688951544 Enrollment ID: I20170501002417 |
| Provider Name | Kasia Nelene Mendoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689186413 PECOS PAC ID: 0345509550 Enrollment ID: I20180116002133 |
| Provider Name | Heather Corinne Jekot Griffith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902284417 PECOS PAC ID: 1759641210 Enrollment ID: I20191011000899 |
| Provider Name | Harry Zane Shen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639533466 PECOS PAC ID: 4385064732 Enrollment ID: I20201023000930 |
| Provider Name | Cristian A Medina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245867092 PECOS PAC ID: 3476979022 Enrollment ID: I20230725003446 |
| Provider Name | Lexi Velasquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184498867 PECOS PAC ID: 8426494907 Enrollment ID: I20240306002948 |
Pecos County Memorial Hospital District Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 511 N Main St, Fort Stockton, TX 79735 Phone: 432-336-2291 | |
Pecos County Memorial Hospital District Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 387 W Ih 10, Fort Stockton, TX 79735 Phone: 432-336-2058 | |
Subodh K Mallik Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2071 N Main St, Fort Stockton, TX 79735 Phone: 432-336-0700 | |
Meridian Health Systems Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 237 W 21st St, Fort Stockton, TX 79735 Phone: 432-336-0700 Fax: 432-336-0704 | |
Family Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 387 W Ih 10, Fort Stockton, TX 79735 Phone: 432-336-2291 Fax: 844-824-3604 | |
Family Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 387 Ih 10 W, Ste 1, Fort Stockton, TX 79735 Phone: 432-336-8365 Fax: 432-336-8392 |