| Killeen Medical Clinic , P.a. | |
|
502 W Jasper Dr Killeen TX 76542-1312 | |
| (254) 526-6300 | |
| (254) 526-6349 |
| Full Name | Killeen Medical Clinic , P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 502 W Jasper Dr, Killeen, Texas |
| Authorized Official Name and Position | Edward E Spencer (MEDICAL DOCTOR) |
| Authorized Official Contact | 2545266300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Killeen Medical Clinic , P.a. 502 W Jasper Dr Killeen TX 76542-1312 Ph: (254) 526-6300 | Killeen Medical Clinic , P.a. 502 W Jasper Dr Killeen TX 76542-1312 Ph: (254) 526-6300 |
| NPI Number | 1588736870 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4981703345 |
|---|---|
| Medicare Enrollment ID | O20070626000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588736870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H0837 (Texas) | Primary |
| Provider Name | Edward E Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548355902 PECOS PAC ID: 9032143086 Enrollment ID: I20050920000789 |
| Provider Name | Alicia Nicole Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114573003 PECOS PAC ID: 4587093604 Enrollment ID: I20200410000511 |
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