Full Name | |
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Speciality | Nurse Practitioner - Family |
Location | 200 N Pearl St, Mart, Texas |
Authorized Official Name and Position | Julie Ann Wilson (CHIEF COMPLIANCE OFFICER) |
Authorized Official Contact | 2547293281 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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701 Mcclintic Dr Groesbeck TX 76642-2128 Ph: (254) 729-3281 | 200 N Pearl St Mart TX 76664-1142 Ph: (254) 729-3281 |
NPI Number | 1275242489 |
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Provider Enumeration Date | 11/16/2022 |
Last Update Date | 10/30/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275242489 | NPI | - | NPPES |