| Mr Wildon Mellinger Rouse Iii, | |
|
1253 N Von Minden St, La Grange, TX 78945-1262 | |
| (979) 968-8493 | |
| (979) 968-6388 |
| Full Name | Mr Wildon Mellinger Rouse Iii |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 27 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 |
|---|---|---|---|
| 1003873845 | NPI | - | NPPES |
| MDF1715TX | Other | TX | WORKERS COMPENSATION |
| 308464202 | Medicaid | TX | |
| 875N33 | Other | TX | BC/BS # |
| P00477542 | Other | TX | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA02598 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Jordan Health Services, A Part Of The Elara Caring | Round rock, TX | Home health agency |
| Columbus Community Hospital | Columbus, TX | Hospital |
| Seton Smithville Regional Hospital | Smithville, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mcbroom Clinic Pa | 5890893119 | 8 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Wildon Mellinger Rouse Iii, 1253 N Von Minden St, La Grange, TX 78945-1262 Ph: (979) 968-8493 | Mr Wildon Mellinger Rouse Iii, 1253 N Von Minden St, La Grange, TX 78945-1262 Ph: (979) 968-8493 |
Jennifer J Emmel, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1253 N Von Minden St, La Grange, TX 78945 Phone: 979-968-8493 Fax: 979-968-6388 | |
Mrs. Hanna Florence Pilat, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1253 N Von Minden St, La Grange, TX 78945 Phone: 979-968-8493 | |
Mrs. Chelsea L Jecmenek, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1253 N Von Minden St, La Grange, TX 78945 Phone: 979-968-8493 Fax: 979-968-6388 |