| Nathan Wallace Anderson, MD | |
|
1253 N Von Minden St, La Grange, TX 78945-1262 | |
| (979) 968-8493 | |
| (979) 968-6388 |
| Full Name | Nathan Wallace Anderson |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 8 Years |
| Location | 1253 N Von Minden St, La Grange, 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 |
|---|---|---|---|
| 1386078715 | NPI | - | NPPES |
| 427582802 | Medicaid | TX | |
| 1386078715 | Medicaid | TX | |
| 427582801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD60866922 (Washington) | Secondary |
| 207Q00000X | Family Medicine | T1634 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Seton Smithville Regional Hospital | Smithville, TX | Hospital |
| Columbus Community Hospital | Columbus, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mcbroom Clinic Pa | 5890893119 | 8 |
| Entity Name | Mcbroom Clinic Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114088093 PECOS PAC ID: 5890893119 Enrollment ID: O20070611000537 |
| Entity Name | Lgfm Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871153775 PECOS PAC ID: 5395075238 Enrollment ID: O20190919001583 |
| Mailing Address | Practice Location Address |
|---|---|
| Nathan Wallace Anderson, MD 6210 E Hwy 290, Austin, TX 78723-1142 Ph: (512) 483-9596 | Nathan Wallace Anderson, MD 1253 N Von Minden St, La Grange, TX 78945-1262 Ph: (979) 968-8493 |
Hans James Raj, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1253 N Von Minden St, La Grange, TX 78945 Phone: 979-968-8493 Fax: 979-968-6388 | |
Kinuyo Henderson, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1253 N. Von Minden, La Grange, TX 78945 Phone: 979-968-8493 Fax: 979-968-6388 | |
Amanda Rosenauer, CFNP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1253 N Von Minden St, La Grange, TX 78945 Phone: 979-968-8493 Fax: 979-968-6388 | |
Dr. Thomas O Borgstedte, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1253 N Von Minden St, La Grange, TX 78945 Phone: 979-968-8493 Fax: 979-968-6388 | |
Dr. William M Mcbroom, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1253 N Von Minden St, La Grange, TX 78945 Phone: 979-968-8493 Fax: 979-968-6388 | |
Dr. Wess James Blackwell, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1253 N Von Minden St, La Grange, TX 78945 Phone: 979-968-8493 |