| Southern Roots Family Care | |
|
400 W. Calvert St , Unit C Troup TX 75789 | |
| (903) 969-5056 | |
| Not Available |
| Full Name | Southern Roots Family Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 400 W. Calvert St , Unit C, Troup, Texas |
| Authorized Official Name and Position | Stephanie Mcclure (FNP-C) |
| Authorized Official Contact | 9039695056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Roots Family Care Po Box 59 400 W. Calvert St, Unit C Troup TX 75789-0059 Ph: (903) 969-5056 | Southern Roots Family Care 400 W. Calvert St , Unit C Troup TX 75789 Ph: (903) 969-5056 |
| NPI Number | 1891487070 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 04/21/2026 |
| Medicare PECOS PAC ID | 9931568755 |
|---|---|
| Medicare Enrollment ID | O20230711002084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891487070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Stephanie Mcclure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225720014 PECOS PAC ID: 3476912205 Enrollment ID: I20230711002324 |
William Boyd Roberson Jr, Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8511 Fm 856 N, Troup, TX 75789 Phone: 903-738-1623 |