| Live Oak Professional Center | |
|
1705 Live Oak St Commerce TX 75428-2551 | |
| (903) 886-8818 | |
| (903) 886-8765 |
| Full Name | Live Oak Professional Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1705 Live Oak St, Commerce, Texas |
| Authorized Official Name and Position | Sue Nixson (OFFICE MANAGER) |
| Authorized Official Contact | 9038868818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Oak Professional Center 1705 Live Oak St Commerce TX 75428-2551 Ph: (903) 886-8818 | Live Oak Professional Center 1705 Live Oak St Commerce TX 75428-2551 Ph: (903) 886-8818 |
| NPI Number | 1508848029 |
|---|---|
| Provider Enumeration Date | 11/18/2005 |
| Last Update Date | 04/05/2023 |
| Medicare PECOS PAC ID | 0042279846 |
|---|---|
| Medicare Enrollment ID | O20041007000421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508848029 | NPI | - | NPPES |
| 111557802 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H0803 (Texas) | Secondary |
| 208D00000X | General Practice | K6628 (Texas) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Keri H Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831441302 PECOS PAC ID: 1355586330 Enrollment ID: I20130321000479 |
| Provider Name | Tamara Diane Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831577311 PECOS PAC ID: 9234432865 Enrollment ID: I20160114001941 |
| Provider Name | Stephanie Slough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124539895 PECOS PAC ID: 9739449422 Enrollment ID: I20180126001500 |
Qv Urgent Care Tx Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1704 Live Oak St, Commerce, TX 75428 Phone: 430-562-8272 | |
Community Health Service Agency, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 606 Culver St, Commerce, TX 75428 Phone: 903-454-3025 Fax: 903-450-1408 | |
Texas A&m University Commerce Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 South Neal, Commerce, TX 75429 Phone: 903-886-5853 Fax: 903-886-5854 | |
Greenville Healthcare Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1700 Washington St, Commerce, TX 75428 Phone: 903-886-9900 Fax: 903-886-9924 | |
Hunt Regional Medical Partners Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1705 Live Oak St, Commerce, TX 75428 Phone: 903-886-8818 Fax: 903-886-8765 |