St Marys Family Clinic Pllc | |
3730 N Josey Ln Ste 120 Carrollton TX 75007-2439 | |
(972) 999-3593 | |
Not Available |
Full Name | St Marys Family Clinic Pllc |
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Speciality | Clinic/Center |
Location | 3730 N Josey Ln Ste 120, Carrollton, Texas |
Authorized Official Name and Position | Remi Thomas (OWNER) |
Authorized Official Contact | 9729993593 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
St Marys Family Clinic Pllc 3730 N Josey Ln Ste 120 Carrollton TX 75007-2439 Ph: (972) 999-3593 | St Marys Family Clinic Pllc 3730 N Josey Ln Ste 120 Carrollton TX 75007-2439 Ph: (972) 999-3593 |
NPI Number | 1619697877 |
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Provider Enumeration Date | 08/29/2022 |
Last Update Date | 09/07/2022 |
Medicare PECOS PAC ID | 3476913641 |
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Medicare Enrollment ID | O20230719002513 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619697877 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Provider Name | Remi Thomas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962089052 PECOS PAC ID: 9436547577 Enrollment ID: I20211022001343 |
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