| Sabine Valley Medical Associates Inc | |
|
4702 Wesley St Ste B Greenville TX 75401-5663 | |
| (214) 683-7481 | |
| (214) 722-6996 |
| Full Name | Sabine Valley Medical Associates Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4702 Wesley St Ste B, Greenville, Texas |
| Authorized Official Name and Position | Penny Jo Pickle Krispin (FNP/OWNER) |
| Authorized Official Contact | 9034500710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sabine Valley Medical Associates Inc 4702 Wesley St Ste B Greenville TX 75401-5663 Ph: (214) 683-7481 | Sabine Valley Medical Associates Inc 4702 Wesley St Ste B Greenville TX 75401-5663 Ph: (214) 683-7481 |
| NPI Number | 1972077063 |
|---|---|
| Provider Enumeration Date | 01/11/2019 |
| Last Update Date | 12/15/2020 |
| Medicare PECOS PAC ID | 7911247887 |
|---|---|
| Medicare Enrollment ID | O20190313001216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972077063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Penny J Pickle Krispin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801237391 PECOS PAC ID: 4587904453 Enrollment ID: I20190314001459 |
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