| Primary & Diagnostic Medical Centers Of Texas | |
|
3829 Saratoga Blvd Corpus Christi TX 78415-5814 | |
| (361) 906-2121 | |
| (361) 906-2264 |
| Full Name | Primary & Diagnostic Medical Centers Of Texas |
|---|---|
| Speciality | Internal Medicine |
| Location | 3829 Saratoga Blvd, Corpus Christi, Texas |
| Authorized Official Name and Position | Mario A Martinez (PRESIDENT) |
| Authorized Official Contact | 3619062121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary & Diagnostic Medical Centers Of Texas Po Box 271567 Corpus Christi TX 78427-1567 Ph: (361) 906-2121 | Primary & Diagnostic Medical Centers Of Texas 3829 Saratoga Blvd Corpus Christi TX 78415-5814 Ph: (361) 906-2121 |
| NPI Number | 1073627071 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 03/31/2014 |
| Medicare PECOS PAC ID | 4284631359 |
|---|---|
| Medicare Enrollment ID | O20061102000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073627071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M3637 (Texas) | Primary |
| Provider Name | Mario A Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861401739 PECOS PAC ID: 0547267619 Enrollment ID: I20061102000295 |
| Provider Name | Lisa Marie Olivares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710313747 PECOS PAC ID: 9638308299 Enrollment ID: I20140131001795 |
| Provider Name | Joseph R Shollenbarger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235574328 PECOS PAC ID: 3375811003 Enrollment ID: I20170621000668 |
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