| Standard Medical Clinic, Pa | |
|
8333 9th Ave., Suite A Port Arthur TX 77642-8151 | |
| (409) 727-2808 | |
| Not Available |
| Full Name | Standard Medical Clinic, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 8333 9th Ave.,, Port Arthur, Texas |
| Authorized Official Name and Position | Oscar Olfindo Enriquez (PRESIDENT) |
| Authorized Official Contact | 4097272808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Standard Medical Clinic, Pa Po Box 4580 Msc 200 Houston TX 77210-4580 Ph: (409) 727-2808 | Standard Medical Clinic, Pa 8333 9th Ave., Suite A Port Arthur TX 77642-8151 Ph: (409) 727-2808 |
| NPI Number | 1316096647 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 12/09/2016 |
| Medicare PECOS PAC ID | 8123071214 |
|---|---|
| Medicare Enrollment ID | O20050301000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316096647 | NPI | - | NPPES |
| 00358Y | Other | TX | MEDICARE GROUP PTAN |
| K0026 | Other | TX | STATE LICENSE |
| 8937M0 | Other | TX | BCBS PROV NO. |
| 172115101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Oscar Enriquez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487737219 PECOS PAC ID: 5294647046 Enrollment ID: I20050303000194 |
| Provider Name | Carolyn Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538533906 PECOS PAC ID: 1254622293 Enrollment ID: I20160621002792 |
| Provider Name | Kristopher Gabas Dela Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821403809 PECOS PAC ID: 9335418847 Enrollment ID: I20170627000171 |
| Provider Name | Connie Denise Johnson-wiltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306354261 PECOS PAC ID: 2466716592 Enrollment ID: I20180426000017 |
| Provider Name | Cynthia Elizabeth Arceneaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861989949 PECOS PAC ID: 0547517567 Enrollment ID: I20180723002331 |
| Provider Name | Tung Van Hoang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578038527 PECOS PAC ID: 9931453966 Enrollment ID: I20181110000128 |
Medplus Mobile Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3636 Professional Dr Ste 2, Port Arthur, TX 77642 Phone: 409-719-6035 | |
First Response Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3620 Highway 365, Suite 400, Port Arthur, TX 77642 Phone: 409-344-4557 Fax: 409-344-4587 | |
Sreedhar Polavarapu Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2501 Jimmy Johnson Blvd, Suite 207, Port Arthur, TX 77642 Phone: 409-722-7500 Fax: 409-293-4401 | |
Allure Healthcare,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3609 9th Ave, Port Arthur, TX 77642 Phone: 409-237-2322 | |
Robert T. Warhola, D.o., P.a Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5885 W Port Arthur Rd, Port Arthur, TX 77640 Phone: 409-736-2800 Fax: 409-736-0361 | |
Premise Health Of Texas Medical, P.a Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 S Gulfway Dr, Port Arthur, TX 77640 Phone: 409-985-1819 Fax: 409-985-1079 | |
Ipc Of Texas Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640 Phone: 409-724-7389 |