| Bequillard & Bequillard Llc | |
|
600 Cut Off Rd Ste 14 Port Aransas TX 78373-4246 | |
| (361) 749-1930 | |
| (361) 749-1933 |
| Full Name | Bequillard & Bequillard Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 600 Cut Off Rd Ste 14, Port Aransas, Texas |
| Authorized Official Name and Position | Amber Bequillard (ADMINISTRATOR) |
| Authorized Official Contact | 3617491930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bequillard & Bequillard Llc 600 Cut Off Rd Suite 14 Port Aransas TX 78373-4246 Ph: (361) 749-1930 | Bequillard & Bequillard Llc 600 Cut Off Rd Ste 14 Port Aransas TX 78373-4246 Ph: (361) 749-1930 |
| NPI Number | 1134385198 |
|---|---|
| Provider Enumeration Date | 07/30/2008 |
| Last Update Date | 05/08/2024 |
| Medicare PECOS PAC ID | 1759510985 |
|---|---|
| Medicare Enrollment ID | O20140210000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134385198 | NPI | - | NPPES |
| 1821670-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 207P00000X (Texas) | Secondary |
| 207Q00000X | Family Medicine | G8391 (Texas) | Primary |
| Provider Name | Bruce Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336134188 PECOS PAC ID: 8022082353 Enrollment ID: I20050607000309 |
| Provider Name | Janie Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144411026 PECOS PAC ID: 5890738116 Enrollment ID: I20140729001760 |
| Provider Name | Chloe Noelle Bequillard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558113332 PECOS PAC ID: 8224562343 Enrollment ID: I20241112004392 |
| Provider Name | Richard Klingler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235186230 PECOS PAC ID: 2961620190 Enrollment ID: I20250311002016 |