| Preventiamed, Pa | |
|
1250 S Capital Of Texas Hwy Building Iii, Suite 400 West Lake Hills TX 78746-6446 | |
| (512) 308-6349 | |
| Not Available |
| Full Name | Preventiamed, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1250 S Capital Of Texas Hwy, West Lake Hills, Texas |
| Authorized Official Name and Position | Dieter Robert Martin (PRESIDENT) |
| Authorized Official Contact | 5123086349 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Preventiamed, Pa 1250 S Capital Of Texas Hwy Building Iii, Suite 400 West Lake Hills TX 78746-6446 Ph: (512) 308-6349 | Preventiamed, Pa 1250 S Capital Of Texas Hwy Building Iii, Suite 400 West Lake Hills TX 78746-6446 Ph: (512) 308-6349 |
| NPI Number | 1134344625 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 10/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134344625 | NPI | - | NPPES |
| 182571301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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