| Ab Genuine Health, Llc | |
|
324 N 14th St Nederland TX 77627-4039 | |
| (409) 351-1507 | |
| Not Available |
| Full Name | Ab Genuine Health, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 324 N 14th St, Nederland, Texas |
| Authorized Official Name and Position | Anasha Bush Butler (OWNER OF ENTITY) |
| Authorized Official Contact | 4093511507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ab Genuine Health, Llc 7635 Erie Dr Nederland TX 77627-5648 Ph: (409) 351-1507 | Ab Genuine Health, Llc 324 N 14th St Nederland TX 77627-4039 Ph: (409) 351-1507 |
| NPI Number | 1568091072 |
|---|---|
| Provider Enumeration Date | 04/06/2020 |
| Last Update Date | 01/26/2023 |
| Medicare PECOS PAC ID | 5991134033 |
|---|---|
| Medicare Enrollment ID | O20200410001579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568091072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Anasha Bush Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104363225 PECOS PAC ID: 1153681473 Enrollment ID: I20180207000431 |
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