Ppm Texas Llc | |
7900 Callaghan Rd Ste 115 San Antonio TX 78229-2327 | |
(888) 253-6598 | |
Not Available |
Full Name | Ppm Texas Llc |
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Speciality | Clinic/Center |
Location | 7900 Callaghan Rd Ste 115, San Antonio, Texas |
Authorized Official Name and Position | Lee Johnson (TREASURER) |
Authorized Official Contact | 2084011400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ppm Texas Llc 1916 N 700 W Ste 110 Layton UT 84041-5754 Ph: (888) 253-6598 | Ppm Texas Llc 7900 Callaghan Rd Ste 115 San Antonio TX 78229-2327 Ph: (888) 253-6598 |
NPI Number | 1518726967 |
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Provider Enumeration Date | 03/18/2024 |
Last Update Date | 03/18/2024 |
Medicare PECOS PAC ID | 5092154195 |
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Medicare Enrollment ID | O20240423001680 |
Identifier | Type | State | Issuer |
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1518726967 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Shelly Nickels |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1891088159 PECOS PAC ID: 4688812092 Enrollment ID: I20140925001089 |
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