| Rockport Rejuvenative Clinic | |
|
1521 W Market St Suite D Rockport TX 78382-6218 | |
| (361) 790-7790 | |
| (361) 790-7785 |
| Full Name | Rockport Rejuvenative Clinic |
|---|---|
| Speciality | Nurse Practitioner - Gerontology |
| Location | 1521 W Market St, Rockport, Texas |
| Authorized Official Name and Position | Margaret Vonheuvel (OWNER) |
| Authorized Official Contact | 3617907790 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rockport Rejuvenative Clinic Po Box 1389 Rockport TX 78381-1389 Ph: (361) 790-7790 | Rockport Rejuvenative Clinic 1521 W Market St Suite D Rockport TX 78382-6218 Ph: (361) 790-7790 |
| NPI Number | 1225263650 |
|---|---|
| Provider Enumeration Date | 05/29/2009 |
| Last Update Date | 03/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225263650 | NPI | - | NPPES |
| 2085508-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Texas) | Secondary |
| 363LG0600X | Nurse Practitioner - Gerontology | (Texas) | Primary |
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