| Diabetes And Cardiovascular Of Rockport, Pllc | |
|
2600 Lakeview Dr Suite D Rockport TX 78382-3552 | |
| (361) 790-5155 | |
| (361) 790-5156 |
| Full Name | Diabetes And Cardiovascular Of Rockport, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 2600 Lakeview Dr, Rockport, Texas |
| Authorized Official Name and Position | Mario Perez (OWNER) |
| Authorized Official Contact | 3617905155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diabetes And Cardiovascular Of Rockport, Pllc 2600 Lakeview Dr Suite D Rockport TX 78382-3552 Ph: (361) 790-5155 | Diabetes And Cardiovascular Of Rockport, Pllc 2600 Lakeview Dr Suite D Rockport TX 78382-3552 Ph: (361) 790-5155 |
| NPI Number | 1033509732 |
|---|---|
| Provider Enumeration Date | 02/02/2015 |
| Last Update Date | 04/24/2015 |
| Medicare PECOS PAC ID | 3072831528 |
|---|---|
| Medicare Enrollment ID | O20150413000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033509732 | NPI | - | NPPES |
| 00N7N0 | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K4526 (Texas) | Secondary |
| 208D00000X | General Practice | J1539 (Texas) | Primary |
| Provider Name | Mario Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841222890 PECOS PAC ID: 8022077999 Enrollment ID: I20041006000931 |
| Provider Name | Christopher Peter Lucci |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1447241955 PECOS PAC ID: 8628100823 Enrollment ID: I20100723000760 |
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