| Reclaim Physicians Medical Group Inc | |
|
913 S Main St Unit 212 Grapevine TX 76051-7582 | |
| (817) 329-4611 | |
| Not Available |
| Full Name | Reclaim Physicians Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 913 S Main St Unit 212, Grapevine, Texas |
| Authorized Official Name and Position | Jon Tryggestad (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 8173294611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reclaim Physicians Medical Group Inc 913 S Main St Unit 212 Grapevine TX 76051-7582 Ph: () - | Reclaim Physicians Medical Group Inc 913 S Main St Unit 212 Grapevine TX 76051-7582 Ph: (817) 329-4611 |
| NPI Number | 1811418023 |
|---|---|
| Provider Enumeration Date | 06/28/2017 |
| Last Update Date | 06/28/2017 |
| Medicare PECOS PAC ID | 6204192321 |
|---|---|
| Medicare Enrollment ID | O20171106002774 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811418023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jivesh Sharma |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1588653406 PECOS PAC ID: 3173583077 Enrollment ID: I20041018000499 |
| Provider Name | James A Mixon |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1033176029 PECOS PAC ID: 8527008515 Enrollment ID: I20050510000193 |
| Provider Name | Anita Tharian |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1457367112 PECOS PAC ID: 3870520232 Enrollment ID: I20050718000985 |
| Provider Name | Mandy Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194749101 PECOS PAC ID: 1052403433 Enrollment ID: I20070815000865 |
| Provider Name | Christian B Helm |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1750585600 PECOS PAC ID: 1153407291 Enrollment ID: I20080328000638 |
| Provider Name | Lance E Groves |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1750338299 PECOS PAC ID: 8123105939 Enrollment ID: I20080403000334 |
| Provider Name | Lauren Elizabeth Letz |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1477733723 PECOS PAC ID: 9830263904 Enrollment ID: I20080807000263 |
| Provider Name | Russell W Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629041827 PECOS PAC ID: 2264563055 Enrollment ID: I20100622000810 |
| Provider Name | Timothy L Davis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1922059807 PECOS PAC ID: 6103084769 Enrollment ID: I20120228000713 |
| Provider Name | Shane E Parker |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548438013 PECOS PAC ID: 2163686296 Enrollment ID: I20120620000853 |
| Provider Name | Joyce Louise Kenebrew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992056816 PECOS PAC ID: 1850543166 Enrollment ID: I20121213000354 |
| Provider Name | Amy P Cripps |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1689622557 PECOS PAC ID: 2567471048 Enrollment ID: I20130821000113 |
| Provider Name | Ricky Lynn Childers |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396855458 PECOS PAC ID: 0547265357 Enrollment ID: I20140131000126 |
| Provider Name | Samantha J Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588197255 PECOS PAC ID: 6305108085 Enrollment ID: I20180316000047 |
| Provider Name | Brad Alan Matlock |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790265528 PECOS PAC ID: 3476804782 Enrollment ID: I20180926001552 |
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