| Puckett Family Clinic, P.c. | |
|
1301 E Main St Honey Grove TX 75446-1268 | |
| (903) 378-3444 | |
| Not Available |
| Full Name | Puckett Family Clinic, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 E Main St, Honey Grove, Texas |
| Authorized Official Name and Position | Paul Laval Puckett (PHYSICIAN ASSISTANT - CERTIFIED) |
| Authorized Official Contact | 9033783444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Puckett Family Clinic, P.c. Po Box 166 Honey Grove TX 75446-0166 Ph: (903) 378-3444 | Puckett Family Clinic, P.c. 1301 E Main St Honey Grove TX 75446-1268 Ph: (903) 378-3444 |
| NPI Number | 1295937449 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 10/25/2012 |
| Medicare PECOS PAC ID | 6103918735 |
|---|---|
| Medicare Enrollment ID | O20070827000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295937449 | NPI | - | NPPES |
| PA02778 | Other | TX | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | PA02778 (Texas) | Primary |
| 363AM0700X | Physician Assistant - Medical | PA02778 (Texas) | Secondary |
| Provider Name | Angela D Ary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689090854 PECOS PAC ID: 3072730720 Enrollment ID: I20140804002274 |
| Provider Name | Gerald J Enox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932688280 PECOS PAC ID: 2264850049 Enrollment ID: I20200910001048 |
Honey Grove Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 447 5th St, Honey Grove, TX 75446 Phone: 903-378-3252 Fax: 903-378-3426 |