| Su Clinica Familiar | |
|
315 N Shiloh Rd Ste 102 Garland TX 75042-5783 | |
| (469) 688-8523 | |
| (469) 458-9121 |
| Full Name | Su Clinica Familiar |
|---|---|
| Speciality | Family Medicine |
| Location | 315 N Shiloh Rd Ste 102, Garland, Texas |
| Authorized Official Name and Position | Jacqueline Balarbar (PRESIDENT) |
| Authorized Official Contact | 4696888523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Su Clinica Familiar 7417 Sugarbush Dr Garland TX 75044-2633 Ph: (469) 688-8523 | Su Clinica Familiar 315 N Shiloh Rd Ste 102 Garland TX 75042-5783 Ph: (469) 688-8523 |
| NPI Number | 1205384138 |
|---|---|
| Provider Enumeration Date | 09/20/2016 |
| Last Update Date | 10/09/2020 |
| Medicare PECOS PAC ID | 5890074066 |
|---|---|
| Medicare Enrollment ID | O20161110000480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205384138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jacqueline A Balarbar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639418239 PECOS PAC ID: 2163651407 Enrollment ID: I20140206001097 |
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