| Primary And Palliative Healthcare Of East Texas,pllc | |
|
8901 E F Lowry Expwy Ste. A Texas City TX 77591 | |
| (409) 933-1003 | |
| (409) 935-0542 |
| Full Name | Primary And Palliative Healthcare Of East Texas,pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8901 E F Lowry Expwy, Texas City, Texas |
| Authorized Official Name and Position | Luis Angel Betancourt (OWNER) |
| Authorized Official Contact | 4099331003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary And Palliative Healthcare Of East Texas,pllc 8901 E F Lowry Expwy Ste A Texas City TX 77591 Ph: (409) 933-1003 | Primary And Palliative Healthcare Of East Texas,pllc 8901 E F Lowry Expwy Ste. A Texas City TX 77591 Ph: (409) 933-1003 |
| NPI Number | 1205552452 |
|---|---|
| Provider Enumeration Date | 10/18/2022 |
| Last Update Date | 10/18/2022 |
| Medicare PECOS PAC ID | 7012389257 |
|---|---|
| Medicare Enrollment ID | O20230216000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205552452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Lena R Bruce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558322438 PECOS PAC ID: 9436170636 Enrollment ID: I20051215000616 |
| Provider Name | Nora I Valdes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124069406 PECOS PAC ID: 0941334080 Enrollment ID: I20100811000879 |
| Provider Name | Derick Deason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528508025 PECOS PAC ID: 0547530057 Enrollment ID: I20170717001027 |
| Provider Name | Shannon Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134649619 PECOS PAC ID: 7416227228 Enrollment ID: I20170726002161 |
| Provider Name | Carl D Lemond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619406717 PECOS PAC ID: 6305105966 Enrollment ID: I20180108000064 |
| Provider Name | Amy Romick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447771290 PECOS PAC ID: 4789928581 Enrollment ID: I20181205002227 |
| Provider Name | Reginald Earl Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992367312 PECOS PAC ID: 2961733183 Enrollment ID: I20191018001300 |
| Provider Name | Luis Betancourt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669835500 PECOS PAC ID: 0648554519 Enrollment ID: I20191227001493 |
| Provider Name | Linda Esmeralda Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841849171 PECOS PAC ID: 1557796398 Enrollment ID: I20200124000124 |
| Provider Name | Tiffany Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972908499 PECOS PAC ID: 5698098366 Enrollment ID: I20200327002188 |
| Provider Name | Shari Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629602354 PECOS PAC ID: 5991136855 Enrollment ID: I20200508000015 |
| Provider Name | Jamie Nicole Leblanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851902993 PECOS PAC ID: 9638580038 Enrollment ID: I20201116000528 |
| Provider Name | Christina Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609409549 PECOS PAC ID: 2769893577 Enrollment ID: I20201201000157 |
| Provider Name | Leila Estela Shirali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972256667 PECOS PAC ID: 3971998634 Enrollment ID: I20220315001900 |
| Provider Name | Tina Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295308286 PECOS PAC ID: 3173999208 Enrollment ID: I20221014001441 |
| Provider Name | Karin Chang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831856426 PECOS PAC ID: 3577937630 Enrollment ID: I20230313002943 |
| Provider Name | Angela Skye Kifer-thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578278487 PECOS PAC ID: 5496120610 Enrollment ID: I20230331000611 |
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