| Shaun Kretzschmar Do Pa | |
|
317 N Fm 1187 Aledo TX 76008-4200 | |
| (817) 441-7181 | |
| (817) 441-7893 |
| Full Name | Shaun Kretzschmar Do Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 317 N Fm 1187, Aledo, Texas |
| Authorized Official Name and Position | Shaun Harding Kretzschmar (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8176146878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaun Kretzschmar Do Pa 317 N Fm 1187 Aledo TX 76008-4200 Ph: (817) 441-7181 | Shaun Kretzschmar Do Pa 317 N Fm 1187 Aledo TX 76008-4200 Ph: (817) 441-7181 |
| NPI Number | 1912379322 |
|---|---|
| Provider Enumeration Date | 10/25/2015 |
| Last Update Date | 08/28/2024 |
| Medicare PECOS PAC ID | 6800192212 |
|---|---|
| Medicare Enrollment ID | O20160311000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912379322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J1940 (Texas) | Secondary |
| 207Q00000X | Family Medicine | J9140 (Texas) | Primary |
| Provider Name | Shaun H Kretzschmar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386675502 PECOS PAC ID: 7517917008 Enrollment ID: I20050122000074 |
| Provider Name | Terri L Stitle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457319162 PECOS PAC ID: 3274534144 Enrollment ID: I20070119000022 |
| Provider Name | Jessica Marie Wight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518503259 PECOS PAC ID: 4183018880 Enrollment ID: I20220223000367 |
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