Texas Family Doctor, P.a. | |
951 E Loop 304 Crockett TX 75835-5403 | |
(936) 655-0500 | |
Not Available |
Full Name | Texas Family Doctor, P.a. |
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Speciality | Family Medicine |
Location | 951 E Loop 304, Crockett, Texas |
Authorized Official Name and Position | Michael Reilly Mcleod (OWNER) |
Authorized Official Contact | 9366550500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Texas Family Doctor, P.a. Po Box 627 Crockett TX 75835-0627 Ph: (936) 655-0500 | Texas Family Doctor, P.a. 951 E Loop 304 Crockett TX 75835-5403 Ph: (936) 655-0500 |
NPI Number | 1629714860 |
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Provider Enumeration Date | 05/10/2022 |
Last Update Date | 05/03/2024 |
Medicare PECOS PAC ID | 3577940923 |
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Medicare Enrollment ID | O20220524002364 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629714860 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Michael Reil Mcleod |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104897750 PECOS PAC ID: 7719968056 Enrollment ID: I20040525000291 |
Provider Name | Kristi Lee Estes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497492086 PECOS PAC ID: 8820472061 Enrollment ID: I20220907001279 |
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