| Providence Mission Ministry Llc | |
|
21 Alpine St Coldspring TX 77331-8058 | |
| (936) 647-2227 | |
| (936) 647-2202 |
| Full Name | Providence Mission Ministry Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 21 Alpine St, Coldspring, Texas |
| Authorized Official Name and Position | Jennifer Nguyen (BUSINESS ACCOUNT MANAGER) |
| Authorized Official Contact | 2817748785 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Mission Ministry Llc Po Box 1293 New Caney TX 77357-1293 Ph: (281) 774-8785 | Providence Mission Ministry Llc 21 Alpine St Coldspring TX 77331-8058 Ph: (936) 647-2227 |
| NPI Number | 1366988412 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 03/08/2020 |
| Medicare PECOS PAC ID | 0345518619 |
|---|---|
| Medicare Enrollment ID | O20170612000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366988412 | NPI | - | NPPES |
| 371798501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tri Minh Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205848033 PECOS PAC ID: 2961402938 Enrollment ID: I20070629000323 |
Walker County Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Hill Ave, Coldspring, TX 77331 Phone: 936-439-1450 | |
Philip R. Wisiackas, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Hill Ave, Coldspring, TX 77331 Phone: 936-653-4223 Fax: 936-653-5042 |