| Waco Functional Medicine, Pa | |
|
318 Richland West Cir Ste B Waco TX 76712-7919 | |
| (254) 776-8009 | |
| Not Available |
| Full Name | Waco Functional Medicine, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 318 Richland West Cir Ste B, Waco, Texas |
| Authorized Official Name and Position | Lisa J Kirk (OWNER) |
| Authorized Official Contact | 2547768009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waco Functional Medicine, Pa 318 Richland West Cir Ste B Waco TX 76712-7919 Ph: (254) 776-8009 | Waco Functional Medicine, Pa 318 Richland West Cir Ste B Waco TX 76712-7919 Ph: (254) 776-8009 |
| NPI Number | 1093016826 |
|---|---|
| Provider Enumeration Date | 11/10/2010 |
| Last Update Date | 11/10/2010 |
| Medicare PECOS PAC ID | 0244416162 |
|---|---|
| Medicare Enrollment ID | O20110510000819 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093016826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K3775 (Texas) | Primary |
| Provider Name | Chanel J Wilkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932104916 PECOS PAC ID: 1153216007 Enrollment ID: I20040218001124 |
| Provider Name | Patricia A Tatum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194862961 PECOS PAC ID: 7315097110 Enrollment ID: I20090617000410 |
| Provider Name | Shelly J Culver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881827822 PECOS PAC ID: 4183751175 Enrollment ID: I20100422001011 |
| Provider Name | Lisa J Kirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578562146 PECOS PAC ID: 8123017308 Enrollment ID: I20100921000573 |
| Provider Name | Laura C Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164696506 PECOS PAC ID: 7113098542 Enrollment ID: I20180104000085 |
| Provider Name | Melissa C Donoso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164918629 PECOS PAC ID: 0345224119 Enrollment ID: I20181015000651 |
Waco Infectious Disease Associates P A Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7030 New Sanger Ave, Ste 202, Waco, TX 76712 Phone: 254-741-1860 Fax: 254-741-1249 | |
Waco Regional Cancer Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3420 Pine Ave, Waco, TX 76708 Phone: 254-752-2900 Fax: 254-752-2902 | |
Careconnect Medical Group P.l.l.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 Lake Shore Dr Apt 121, Waco, TX 76708 Phone: 254-498-6671 | |
Medico Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1437 S. Valley Mills Drive, Waco, TX 76711 Phone: 254-221-1901 Fax: 254-221-1909 | |
Mark H. Dickie, Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 782 Dry Creek Rd, Waco, TX 76705 Phone: 254-870-4417 Fax: 254-230-4493 | |
Slsp Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 W Hwy 6, Suite 108, Waco, TX 76710 Phone: 254-776-5900 Fax: 254-776-5921 |