| Tracey A Antill, DO | |
|
301 Medic Ln, Alvin, TX 77511-5542 | |
| (281) 331-6141 | |
| (281) 331-3316 |
| Full Name | Tracey A Antill |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 301 Medic Ln, Alvin, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497730303 | NPI | - | NPPES |
| 1497730303 | Other | TX | TRICARE SOUTH |
| 131166408 | Medicaid | TX | |
| 8F9296 | Other | TX | BCBSTX PROV NO |
| 131166409 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | K2308 (Texas) | Primary |
| Entity Name | Bryan Emergency Physicians Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417995481 PECOS PAC ID: 7416840574 Enrollment ID: O20040204000121 |
| Entity Name | Brazos Valley Emergency Physicians Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982642955 PECOS PAC ID: 0749276772 Enrollment ID: O20040521001234 |
| Entity Name | Aic Urgent Care. Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962788125 PECOS PAC ID: 5890956650 Enrollment ID: O20120423000372 |
| Entity Name | Century Integrated Partners, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447615711 PECOS PAC ID: 6406151703 Enrollment ID: O20160224002152 |
| Entity Name | Texana Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306202098 PECOS PAC ID: 6901103555 Enrollment ID: O20160328000734 |
| Mailing Address | Practice Location Address |
|---|---|
| Tracey A Antill, DO Po Box 200993, Houston, TX 77216-0993 Ph: (281) 784-1111 | Tracey A Antill, DO 301 Medic Ln, Alvin, TX 77511-5542 Ph: (281) 331-6141 |
Richard H Leconey, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 301 Medic Ln, Alvin, TX 77511 Phone: 281-331-6141 Fax: 281-331-3316 | |
Abel R Longoria, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 301 Medic Ln, Alvin, TX 77511 Phone: 281-331-6141 Fax: 281-331-3316 | |
Tarek Koussayer, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 301 Medic Ln, Alvin, TX 77511 Phone: 281-331-6141 Fax: 281-331-3316 | |
James S Vincent, MD Emergency Medicine Medicare: May Accept Medicare Assignments Practice Location: 301 Medic Ln, Alvin, TX 77511 Phone: 281-331-6141 Fax: 281-331-3316 | |
Richard J Loynes, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 301 Medic Ln, Alvin, TX 77511 Phone: 281-331-6141 Fax: 281-331-3316 | |
David R Hoyer Jr., M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 301 Medic Ln, Alvin, TX 77511 Phone: 281-331-6141 Fax: 281-331-3316 |