| Tall City Convenient Primary Care | |
|
4519 N Garfield St Suite 6 Midland TX 79705-3415 | |
| (432) 352-4443 | |
| Not Available |
| Full Name | Tall City Convenient Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 4519 N Garfield St, Midland, Texas |
| Authorized Official Name and Position | Philip D Talley (CO-OWNER) |
| Authorized Official Contact | 4323524443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tall City Convenient Primary Care 4519 N Garfield St Suite 6 Midland TX 79705-3415 Ph: (432) 352-4443 | Tall City Convenient Primary Care 4519 N Garfield St Suite 6 Midland TX 79705-3415 Ph: (432) 352-4443 |
| NPI Number | 1528451101 |
|---|---|
| Provider Enumeration Date | 03/06/2015 |
| Last Update Date | 06/24/2016 |
| Medicare PECOS PAC ID | 9931494028 |
|---|---|
| Medicare Enrollment ID | O20160829001944 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528451101 | NPI | - | NPPES |
| Provider Name | Nikki N Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780963496 PECOS PAC ID: 1355513813 Enrollment ID: I20111006000236 |
| Provider Name | Raynell Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013071448 PECOS PAC ID: 0345490207 Enrollment ID: I20121030000588 |
| Provider Name | Bhawana Bista |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578812434 PECOS PAC ID: 9032333554 Enrollment ID: I20160606000067 |
| Provider Name | Margaret O Egbonim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023567401 PECOS PAC ID: 2769761816 Enrollment ID: I20161114002039 |
| Provider Name | Philip Talley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720402365 PECOS PAC ID: 2163640996 Enrollment ID: I20170324000371 |
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