| Charles Gregory, Do Pa | |
|
1500 Wildcat Dr Ste C Portland TX 78374-2826 | |
| (361) 643-9800 | |
| (361) 643-5112 |
| Full Name | Charles Gregory, Do Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1500 Wildcat Dr Ste C, Portland, Texas |
| Authorized Official Name and Position | Charles Gregory (OWNER) |
| Authorized Official Contact | 3616439800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Gregory, Do Pa 1500 Wildcat Dr Ste C Portland TX 78374-2826 Ph: (361) 643-9800 | Charles Gregory, Do Pa 1500 Wildcat Dr Ste C Portland TX 78374-2826 Ph: (361) 643-9800 |
| NPI Number | 1952420804 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 04/19/2025 |
| Medicare PECOS PAC ID | 6002838919 |
|---|---|
| Medicare Enrollment ID | O20051220000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952420804 | NPI | - | NPPES |
| 179568401 | Medicaid | TX | |
| 0037MY | Other | TX | BCBS TX GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L7737 (Texas) | Primary |
| Provider Name | Charles C Gregory |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477581221 PECOS PAC ID: 7113944257 Enrollment ID: I20051028000254 |
| Provider Name | Gloria Perales Solis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265873095 PECOS PAC ID: 4284864364 Enrollment ID: I20140312000266 |
| Provider Name | Bonnie M Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740916808 PECOS PAC ID: 0446697098 Enrollment ID: I20240319002476 |
Darryl Dewitt Collins, M.d.,p.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 213 Cedar Dr, Suite A, Portland, TX 78374 Phone: 361-777-2886 Fax: 361-777-3667 | |
Jerome Lee Sang Md, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 Cedar Dr, Portland, TX 78374 Phone: 361-643-6623 | |
Mcjv Medical Partners, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 443 Houston St, Portland, TX 78374 Phone: 361-977-2059 | |
David Heredia Md. Pa. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Wildcat Dr, Suite H, Portland, TX 78374 Phone: 361-777-3330 Fax: 361-777-2811 | |
Coastal Plains Community Mhmr Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Marriott Dr, Portland, TX 78374 Phone: 361-777-3991 | |
Mcjv Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 614 Elm St, Portland, TX 78374 Phone: 361-563-2966 |