| Midsouth Homecare Pllc | |
|
5904 Summerfield Dr Texarkana TX 75503-4306 | |
| (430) 278-0005 | |
| (430) 278-0006 |
| Full Name | Midsouth Homecare Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5904 Summerfield Dr, Texarkana, Texas |
| Authorized Official Name and Position | Vernon Dean Bowman (PRESIDENT) |
| Authorized Official Contact | 4302004350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midsouth Homecare Pllc 5904 Summerfield Dr Texarkana TX 75503-4306 Ph: (430) 278-0005 | Midsouth Homecare Pllc 5904 Summerfield Dr Texarkana TX 75503-4306 Ph: (430) 278-0005 |
| NPI Number | 1295325611 |
|---|---|
| Provider Enumeration Date | 01/20/2021 |
| Last Update Date | 02/26/2025 |
| Medicare PECOS PAC ID | 3173051091 |
|---|---|
| Medicare Enrollment ID | O20250106002885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295325611 | NPI | - | NPPES |
| Provider Name | C Renee Branch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205814753 PECOS PAC ID: 4183511652 Enrollment ID: I20040301000327 |
| Provider Name | Vernon D Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053311068 PECOS PAC ID: 1557344595 Enrollment ID: I20071024000463 |
| Provider Name | Jean Georges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629342514 PECOS PAC ID: 3577727536 Enrollment ID: I20120604000489 |
| Provider Name | Jennifer Nicole Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215468897 PECOS PAC ID: 6103194758 Enrollment ID: I20191008001100 |
| Provider Name | Amanda J Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306365358 PECOS PAC ID: 9032476338 Enrollment ID: I20191203000258 |
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