| Family Medical Center of Georgetown, PA | |
|
908 Rockmoor Dr Georgetown TX 78628-8966 | |
| (512) 868-0901 | |
| (512) 868-1527 |
| Full Name | Family Medical Center of Georgetown, PA |
|---|---|
| Speciality | Family Medicine |
| Location | 908 Rockmoor Dr, Georgetown, Texas |
| Authorized Official Name and Position | Richard E Otto (CO-OWNER) |
| Authorized Official Contact | 5128680901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Center of Georgetown, PA Po Box 2509 Georgetown TX 78627-2509 Ph: (512) 868-0901 | Family Medical Center of Georgetown, PA 908 Rockmoor Dr Georgetown TX 78628-8966 Ph: (512) 868-0901 |
| NPI Number | 1700946118 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 07/01/2010 |
| Medicare PECOS PAC ID | 3870564867 |
|---|---|
| Medicare Enrollment ID | O20040803001595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700946118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Richard E Otto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730266420 PECOS PAC ID: 0446221428 Enrollment ID: I20040803001439 |
| Provider Name | Murray a Snook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326125097 PECOS PAC ID: 0244201242 Enrollment ID: I20070830000115 |
| Provider Name | Marcus J Wauson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346418076 PECOS PAC ID: 5799856514 Enrollment ID: I20080620000443 |
| Provider Name | Candice N Weiner Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831519826 PECOS PAC ID: 4789989906 Enrollment ID: I20191021000587 |
| Provider Name | Emily S Gonzalez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073198438 PECOS PAC ID: 2062820558 Enrollment ID: I20210422000560 |
| Provider Name | Cody H Haines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679233944 PECOS PAC ID: 8224420682 Enrollment ID: I20220113002900 |
| Provider Name | Nihal Ozbasaran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275479131 PECOS PAC ID: 1052882065 Enrollment ID: I20260609004650 |
| Provider Name | Taylor S Dornseifer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053266551 PECOS PAC ID: 6709358492 Enrollment ID: I20260612004142 |
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