| Heritage Inter-med, Pllc | |
|
1121 N Joe Wilson Rd Cedar Hill TX 75104-1430 | |
| (972) 299-0003 | |
| (972) 299-0004 |
| Full Name | Heritage Inter-med, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1121 N Joe Wilson Rd, Cedar Hill, Texas |
| Authorized Official Name and Position | Cecil Cedric Bailey (OWNER) |
| Authorized Official Contact | 9722990003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Inter-med, Pllc 1121 N Joe Wilson Rd Cedar Hill TX 75104-1430 Ph: (972) 299-0003 | Heritage Inter-med, Pllc 1121 N Joe Wilson Rd Cedar Hill TX 75104-1430 Ph: (972) 299-0003 |
| NPI Number | 1013136787 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 01/27/2017 |
| Medicare PECOS PAC ID | 2365528494 |
|---|---|
| Medicare Enrollment ID | O20080328000516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013136787 | NPI | - | NPPES |
| 203079301 | Medicaid | TX | |
| 392541 | Other | TX | WELLCARE |
| DQ8950 | Other | TX | RAILROAD MEDICARE |
| 0158180352 | Other | TX | SECURE HORIZONS |
| 7809231 | Other | TX | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Cecil C Bailey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871546598 PECOS PAC ID: 5890684476 Enrollment ID: I20040913000884 |
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