| Island Physicians Llc | |
|
600 Elizabeth St Building B, 4th Floor Corpus Christi TX 78404 | |
| (361) 371-8933 | |
| Not Available |
| Full Name | Island Physicians Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 600 Elizabeth St, Corpus Christi, Texas |
| Authorized Official Name and Position | Brent Pennington (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3619851221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Physicians Llc Po Box 6696 Corpus Christi TX 78466-6696 Ph: (361) 985-1221 | Island Physicians Llc 600 Elizabeth St Building B, 4th Floor Corpus Christi TX 78404 Ph: (361) 371-8933 |
| NPI Number | 1134997158 |
|---|---|
| Provider Enumeration Date | 12/19/2023 |
| Last Update Date | 12/19/2023 |
| Medicare PECOS PAC ID | 4183076037 |
|---|---|
| Medicare Enrollment ID | O20240117000886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134997158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Brent Lee Pennington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205098753 PECOS PAC ID: 7416105457 Enrollment ID: I20131120001852 |
| Provider Name | Andrew Aoshima |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831578665 PECOS PAC ID: 9436403847 Enrollment ID: I20200203000300 |
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