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102 N Us Highway 277 Eldorado TX 76936 | |
(325) 853-2507 | |
(325) 853-3166 |
Full Name | |
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Speciality | Family Medicine |
Location | 102 N Us Highway 277, Eldorado, Texas |
Authorized Official Name and Position | Donald A. Freeman (PRESIDENT) |
Authorized Official Contact | 4058780202 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box V Eldorado TX 76936 Ph: (325) 853-2507 | 102 N Us Highway 277 Eldorado TX 76936 Ph: (325) 853-2507 |
NPI Number | 1457405136 |
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Provider Enumeration Date | 01/22/2007 |
Last Update Date | 07/29/2014 |
Medicare PECOS PAC ID | 5799707618 |
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Medicare Enrollment ID | O20060112000946 |
Identifier | Type | State | Issuer |
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1457405136 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Walter Gordy Day |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942239207 PECOS PAC ID: 9032188834 Enrollment ID: I20040928001356 |
Provider Name | Karla D Morrow |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093708448 PECOS PAC ID: 2365457322 Enrollment ID: I20060213000141 |
Provider Name | Selina Andrea Burt |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942511159 PECOS PAC ID: 6608047519 Enrollment ID: I20110927000059 |
Provider Name | Kimberly Babb |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992252951 PECOS PAC ID: 1456634922 Enrollment ID: I20170207001100 |
Provider Name | Samuel Clinton Luedecke |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043762149 PECOS PAC ID: 9830452929 Enrollment ID: I20180425000657 |
Provider Name | James Heath Mitchell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548729262 PECOS PAC ID: 8022351873 Enrollment ID: I20190517000425 |
Provider Name | Kristina Jean Prater |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093318669 PECOS PAC ID: 4789098401 Enrollment ID: I20210120002572 |
Provider Name | Marc Mesch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144992082 PECOS PAC ID: 7911395140 Enrollment ID: I20211020003030 |