| Your Medical Home | |
|
1650 Texas Ave Ste E Bridge City TX 77611-3501 | |
| (833) 698-6825 | |
| Not Available |
| Full Name | Your Medical Home |
|---|---|
| Speciality | Clinic/Center |
| Location | 1650 Texas Ave Ste E, Bridge City, Texas |
| Authorized Official Name and Position | Kyle Perterson (MD) |
| Authorized Official Contact | 4093449277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Medical Home 1650 Texas Ave Ste E Bridge City TX 77611-3501 Ph: (409) 792-5521 | Your Medical Home 1650 Texas Ave Ste E Bridge City TX 77611-3501 Ph: (833) 698-6825 |
| NPI Number | 1811495575 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 02/14/2024 |
| Medicare PECOS PAC ID | 5799040754 |
|---|---|
| Medicare Enrollment ID | O20180523001172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811495575 | NPI | - | NPPES |
| Provider Name | Kyle D Peterson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922335199 PECOS PAC ID: 9739228644 Enrollment ID: I20091207000542 |
| Provider Name | Ibrahim Mansour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578807590 PECOS PAC ID: 4082834841 Enrollment ID: I20140930002154 |
| Provider Name | Beverly A Prejean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184961856 PECOS PAC ID: 7911149729 Enrollment ID: I20150922002690 |
| Provider Name | Marni G Underwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891797304 PECOS PAC ID: 3678558525 Enrollment ID: I20180507000548 |
| Provider Name | Kelsi Strahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770134363 PECOS PAC ID: 3274967682 Enrollment ID: I20191217003355 |
| Provider Name | Adam Jaynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154875441 PECOS PAC ID: 4082010087 Enrollment ID: I20210830003127 |
| Provider Name | Caitlin Joy Veazey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295259679 PECOS PAC ID: 9436529906 Enrollment ID: I20221227000274 |
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