| Jack K Willis Jr, PA | |
|
4060 Medical Park Dr # A, Odessa, TX 79765-2233 | |
| (432) 582-2882 | |
| (432) 582-2884 |
| Full Name | Jack K Willis Jr |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 18 Years |
| Location | 4060 Medical Park Dr # A, Odessa, 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 |
|---|---|---|---|
| 1063664183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA05950 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Medical Center Hospital | Odessa, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Francisco J. Salcido, M.d. P.a. | 7618152281 | 8 |
| Entity Name | Basin Emergency Physicians PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831337724 PECOS PAC ID: 0244397826 Enrollment ID: O20090326000107 |
| Entity Name | Francisco J. Salcido, M.D. P.A. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659679926 PECOS PAC ID: 7618152281 Enrollment ID: O20110425000590 |
| Entity Name | Lubbock Primary Care, PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679011621 PECOS PAC ID: 1951687946 Enrollment ID: O20170405001118 |
| Mailing Address | Practice Location Address |
|---|---|
| Jack K Willis Jr, PA 4060 Medical Park Dr, Odessa, TX 79765-2233 Ph: (432) 582-2882 | Jack K Willis Jr, PA 4060 Medical Park Dr # A, Odessa, TX 79765-2233 Ph: (432) 582-2882 |
Tina M Butler, P.A-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 500 E 4th St, Odessa, TX 79761 Phone: 432-580-8686 Fax: 432-582-2302 |
Hanh Hoang Lovitt, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 500 W 4th St, Odessa, TX 79761 Phone: 432-640-4000 |
Md Moinul Islam, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 6030 W. University, Odessa, TX 79764 Phone: 432-640-6600 Fax: 432-640-4790 |
Madison Cross, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4060 Medical Park Dr, Odessa, TX 79765 Phone: 432-582-2882 Fax: 432-582-2884 |
Mr. Richard L Mittan, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4040 Medical Park Dr, Odessa, TX 79765 Phone: 432-333-6603 Fax: 432-333-8014 |
Mrs. Dayna Lavallee, Physician Assistant Medicare: Medicare Enrolled Practice Location: 401 E 6th St, Odessa, TX 79761 Phone: 432-582-2280 |
Miranda Nhoy, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4060 Medical Park Dr, Odessa, TX 79765 Phone: 432-582-2882 Fax: 432-582-2884 |