Cameron Trace Landreth, PA-C is a medicare enrolled "Physician Assistant - Medical" physician in San Antonio, Texas. His current practice location is
12000 Huebner Rd Ste 104, San Antonio, Texas. You can reach out to his office (for appointments etc.) via phone at
(210) 561-2422.
Cameron Trace Landreth is licensed to practice in Texas (license number PA12024) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1659866119.
Physician's Profile
| Full Name | Cameron Trace Landreth |
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| Gender | Male |
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| Speciality | Physician Assistant - Medical |
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| Location | 12000 Huebner Rd Ste 104, San Antonio, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1659866119
- Provider Enumeration Date: 06/27/2018
- Last Update Date: 04/04/2019
Medicare PECOS Information:
- PECOS PAC ID: 5597007203
- Enrollment ID: I20190430000155
Medical Identifiers
Medical identifiers for Cameron Trace Landreth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1659866119 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | PA12024 (Texas) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA12024 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Cameron Trace Landreth is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Cameron Trace Landreth, PA-C 12000 Huebner Rd Ste 204, San Antonio, TX 78230-1213 Ph: (210) 561-2422 | Cameron Trace Landreth, PA-C 12000 Huebner Rd Ste 104, San Antonio, TX 78230-1209 Ph: (210) 561-2422 |
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