| David N Podgurecki, Md Pa | |
|
1670 E Broad St Suite 102 Mansfield TX 76063-1862 | |
| (817) 473-2228 | |
| Not Available |
| Full Name | David N Podgurecki, Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1670 E Broad St, Mansfield, Texas |
| Authorized Official Name and Position | Greg Podgurecki (SUPERVISER BILLER) |
| Authorized Official Contact | 8175614885 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David N Podgurecki, Md Pa 4110 Flower Garden Dr Arlington TX 76016-3919 Ph: () - | David N Podgurecki, Md Pa 1670 E Broad St Suite 102 Mansfield TX 76063-1862 Ph: (817) 473-2228 |
| NPI Number | 1871758573 |
|---|---|
| Provider Enumeration Date | 07/22/2008 |
| Last Update Date | 11/25/2008 |
| Medicare PECOS PAC ID | 7517027444 |
|---|---|
| Medicare Enrollment ID | O20081121000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871758573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | F3290 (Texas) | Primary |
| Provider Name | David N Podgurecki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720167653 PECOS PAC ID: 5294895256 Enrollment ID: I20081120000324 |
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