| Matagorda Medical Group | |
|
600 Hospital Cir Bay City TX 77414-4771 | |
| (979) 245-0001 | |
| (979) 244-8103 |
| Full Name | Matagorda Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 600 Hospital Cir, Bay City, Texas |
| Authorized Official Name and Position | Derrell M Havins (VICE PRESIDENT) |
| Authorized Official Contact | 8067911591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matagorda Medical Group 2950 50th St Lubbock TX 79413-4326 Ph: (806) 791-1591 | Matagorda Medical Group 600 Hospital Cir Bay City TX 77414-4771 Ph: (979) 245-0001 |
| NPI Number | 1053672535 |
|---|---|
| Provider Enumeration Date | 05/31/2012 |
| Last Update Date | 12/13/2019 |
| Medicare PECOS PAC ID | 4082862487 |
|---|---|
| Medicare Enrollment ID | O20120910000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053672535 | NPI | - | NPPES |
| Provider Name | Alan N Byrd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528037629 PECOS PAC ID: 0941252142 Enrollment ID: I20050216000298 |
| Provider Name | Cheryl F Sacco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174523757 PECOS PAC ID: 7618914144 Enrollment ID: I20050908000882 |
| Provider Name | Jerry D Young |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154408235 PECOS PAC ID: 5294750386 Enrollment ID: I20051007000512 |
| Provider Name | Gregory A Pappas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720040413 PECOS PAC ID: 3779685177 Enrollment ID: I20070302000095 |
| Provider Name | Ladonna P Rutledge |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194813550 PECOS PAC ID: 3577669696 Enrollment ID: I20070507000598 |
| Provider Name | Fabricio J Zuniga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154464055 PECOS PAC ID: 7810080645 Enrollment ID: I20070910000507 |
| Provider Name | Hemant P Dand |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841217783 PECOS PAC ID: 8628120060 Enrollment ID: I20090716000420 |
| Provider Name | Craig L Mcdonald |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356393854 PECOS PAC ID: 2668474131 Enrollment ID: I20091008000217 |
| Provider Name | Louis I Ambeaux |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124220306 PECOS PAC ID: 7911041405 Enrollment ID: I20100222000672 |
| Provider Name | Michael Coburn |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881784536 PECOS PAC ID: 4082771092 Enrollment ID: I20101221000510 |
| Provider Name | Christopher Reilly |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346298577 PECOS PAC ID: 8729012380 Enrollment ID: I20110112000887 |
| Provider Name | Palivela P Raju |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1699758664 PECOS PAC ID: 9032372263 Enrollment ID: I20120525000005 |
| Provider Name | Stacey L Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366867129 PECOS PAC ID: 4183847924 Enrollment ID: I20140522001948 |
| Provider Name | Farah Akhtar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427219369 PECOS PAC ID: 0143446393 Enrollment ID: I20140723001781 |
| Provider Name | Stephanie Marie Zuniga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013262989 PECOS PAC ID: 6800118266 Enrollment ID: I20141215000824 |
| Provider Name | Debra E Shield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659788891 PECOS PAC ID: 4880911973 Enrollment ID: I20150331000237 |
| Provider Name | Samit Soni |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1073753091 PECOS PAC ID: 4880902535 Enrollment ID: I20150930001702 |
| Provider Name | Vicki Lynn Landis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194067066 PECOS PAC ID: 1557597515 Enrollment ID: I20180305001269 |
| Provider Name | Melissa M Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275019812 PECOS PAC ID: 6709134802 Enrollment ID: I20180807000543 |
| Provider Name | Justin Wong |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184919144 PECOS PAC ID: 4284978511 Enrollment ID: I20181127002902 |
| Provider Name | Wayne Yan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1912141086 PECOS PAC ID: 0446579585 Enrollment ID: I20200803002771 |
| Provider Name | Travis G Tomek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578097929 PECOS PAC ID: 4981972460 Enrollment ID: I20200827001011 |
| Provider Name | Meaghan Renee White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710564216 PECOS PAC ID: 7618385527 Enrollment ID: I20210414000645 |
| Provider Name | Eric Teller |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700097326 PECOS PAC ID: 3173537735 Enrollment ID: I20221215000238 |
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