| Dr Kevin John Formes, DO | |
|
2604 Saint Michael Dr Ste 346, Texarkana, TX 75503-2378 | |
| (903) 614-5750 | |
| Not Available |
| Full Name | Dr Kevin John Formes |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 22 Years |
| Location | 2604 Saint Michael Dr Ste 346, Texarkana, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497878474 | NPI | - | NPPES |
| 211561001 | Medicaid | TX | |
| P00836010 | Other | TX | RR MEDICARE |
| 182168003 | Medicaid | AR | |
| 200287540A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0011X | Internal Medicine - Interventional Cardiology | M0077 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Christus St Michael Health System | Texarkana, TX | Hospital |
| Howard Memorial Hospital | Nashville, AR | Hospital |
| Magnolia Hospital | Magnolia, AR | Hospital |
| Wadley Regional Medical Center At Hope | Hope, AR | Hospital |
| Christus Mother Frances Hospital | Tyler, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Christus Trinity Clinic | 3072426741 | 1246 |
| Entity Name | Christus Trinity Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285684225 PECOS PAC ID: 3072426741 Enrollment ID: O20031204001091 |
| Entity Name | Permian Premier Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285664763 PECOS PAC ID: 8426051293 Enrollment ID: O20060816000446 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kevin John Formes, DO 1002 Texas Blvd, Suite 401, Texarkana, TX 75501-5107 Ph: (903) 794-8820 | Dr Kevin John Formes, DO 2604 Saint Michael Dr Ste 346, Texarkana, TX 75503-2378 Ph: (903) 614-5750 |
Dr. Douglas Scott Black, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1002 Texas Blvd, Suite 401, Texarkana, TX 75501 Phone: 903-794-8820 Fax: 903-794-8878 | |
Charles Chibundu Mbonu, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2604 St. Michael Drive, Suite 310, Texarkana, TX 75503 Phone: 903-614-5001 Fax: 903-614-5077 | |
Jonathan F Thomas, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5002 Cowhorn Creek Rd, Texarkana, TX 75503 Phone: 903-614-3000 Fax: 903-614-3525 | |
Mrs. Michelle R Dehan, RN, ACNP Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1550 Moores Ln, Texarkana, TX 75503 Phone: 903-793-7378 | |
Job Jacob, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5002 Cowhorn Creek Rd, Texarkana, TX 75503 Phone: 903-614-3000 Fax: 903-614-3525 | |
Jayendra D. Patel, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2600 Saint Michael Dr, Texarkana, TX 75503 Phone: 903-614-2111 Fax: 903-614-6913 | |
Dr. Thomas Alston, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1400 College Dr, Ste 202, Texarkana, TX 75503 Phone: 903-735-5330 |