Scb Clinic, Pllc | |
120 Flag Lake Dr Ste 2 Lake Jackson TX 77566 | |
(979) 297-8800 | |
(979) 297-0300 |
Full Name | Scb Clinic, Pllc |
---|---|
Speciality | Clinic/Center |
Location | 120 Flag Lake Dr Ste 2, Lake Jackson, Texas |
Authorized Official Name and Position | Stephani Curtis Bradley (PROVIDER) |
Authorized Official Contact | 9792978800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Scb Clinic, Pllc 120 Flag Lake Dr Ste 2 Lake Jackson TX 77566-6292 Ph: (979) 297-8800 | Scb Clinic, Pllc 120 Flag Lake Dr Ste 2 Lake Jackson TX 77566 Ph: (979) 297-8800 |
NPI Number | 1558465286 |
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Provider Enumeration Date | 09/12/2006 |
Last Update Date | 11/21/2022 |
Medicare PECOS PAC ID | 2769496918 |
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Medicare Enrollment ID | O20060126001009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558465286 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 574974 (Texas) | Primary |
Provider Name | Stephani C Bradley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275626913 PECOS PAC ID: 3375596414 Enrollment ID: I20050301000259 |
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