| Phillip W. Jansen | |
|
540 W 15th St Hereford TX 79045-2820 | |
| (803) 364-7512 | |
| Not Available |
| Full Name | Phillip W. Jansen |
|---|---|
| Speciality | Family Medicine |
| Location | 540 W 15th St, Hereford, Texas |
| Authorized Official Name and Position | Phillip Wayne Jansen (PRESIDENT) |
| Authorized Official Contact | 8038472175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phillip W. Jansen 113 N Texas St Hereford TX 79045-4225 Ph: (803) 847-2175 | Phillip W. Jansen 540 W 15th St Hereford TX 79045-2820 Ph: (803) 364-7512 |
| NPI Number | 1336012046 |
|---|---|
| Provider Enumeration Date | 09/29/2025 |
| Last Update Date | 05/06/2026 |
| Certification Date | 05/06/2026 |
| Medicare PECOS PAC ID | 6204306970 |
|---|---|
| Medicare Enrollment ID | O20260525000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336012046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Phillip Wayne Jansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407887318 PECOS PAC ID: 3870588668 Enrollment ID: I20260304003610 |
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