| Carefirst Medical Associates And Pain Rehabilitation, Pa | |
|
13027 State Highway 155 S Tyler TX 75703-6548 | |
| (903) 839-1000 | |
| (903) 839-4000 |
| Full Name | Carefirst Medical Associates And Pain Rehabilitation, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 13027 State Highway 155 S, Tyler, Texas |
| Authorized Official Name and Position | Randall W Rodgers (PHYSICIAN-PRESIDENT) |
| Authorized Official Contact | 9038391000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carefirst Medical Associates And Pain Rehabilitation, Pa 13027 State Highway 155 S Tyler TX 75703-6548 Ph: (903) 839-1000 | Carefirst Medical Associates And Pain Rehabilitation, Pa 13027 State Highway 155 S Tyler TX 75703-6548 Ph: (903) 839-1000 |
| NPI Number | 1114953767 |
|---|---|
| Provider Enumeration Date | 06/24/2006 |
| Last Update Date | 08/16/2016 |
| Medicare PECOS PAC ID | 3173533155 |
|---|---|
| Medicare Enrollment ID | O20060504000838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114953767 | NPI | - | NPPES |
| 1114953767 | Other | TX | BCBSTX |
| DF1536 | Other | TX | RAILROAD MEDICARE |
| 0076NH | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | (* (Not Available)) | Secondary |
| Provider Name | Randall W Rodgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104852888 PECOS PAC ID: 0840261376 Enrollment ID: I20040806000235 |
| Provider Name | Chelsie Lee Flores |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1770873283 PECOS PAC ID: 8426228818 Enrollment ID: I20110822000304 |
| Provider Name | Robert Fenton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124491808 PECOS PAC ID: 7618277377 Enrollment ID: I20151202000287 |
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