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150 River North Blvd Stephenville TX 76401-1803 | |
| (254) 968-6051 | |
| (254) 968-4950 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 150 River North Blvd, Stephenville, Texas |
| Authorized Official Name and Position | Janie Mcmillion (PHYSICIAN CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 2549686051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
150 River North Blvd Stephenville TX 76401-1803 Ph: (254) 968-6051 | 150 River North Blvd Stephenville TX 76401-1803 Ph: (254) 968-6051 |
| NPI Number | 1912902826 |
|---|---|
| Provider Enumeration Date | 06/16/2005 |
| Last Update Date | 11/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912902826 | NPI | - | NPPES |
| 112052901 | Medicaid | TX | |
| 112052902 | Medicaid | TX | |
| 00E762 | Other | TX | GROUP BCBS PROVIDER NUMBE |
| 0411240001 | Other | TX | DME CIGNA GOVERNMENT SERV |
| CA8089 | Other | TX | GROUP RAILROAD MEDICARE # |
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