| Roderick D. Ekmark, Md, Pa | |
|
101 Woodbridge Dr Bldg B Ste 101 And 102 La Vernia TX 78121-0109 | |
| (830) 581-8027 | |
| Not Available |
| Full Name | Roderick D. Ekmark, Md, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 101 Woodbridge Dr Bldg B, La Vernia, Texas |
| Authorized Official Name and Position | Roderick D Ekmark (PRESIDENT) |
| Authorized Official Contact | 8305818027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roderick D. Ekmark, Md, Pa Po Box 1482 La Vernia TX 78121-1422 Ph: (830) 216-3121 | Roderick D. Ekmark, Md, Pa 101 Woodbridge Dr Bldg B Ste 101 And 102 La Vernia TX 78121-0109 Ph: (830) 581-8027 |
| NPI Number | 1861181364 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 01/17/2024 |
| Medicare PECOS PAC ID | 9335506211 |
|---|---|
| Medicare Enrollment ID | O20230608000664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861181364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Roderick David Ekmark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063693398 PECOS PAC ID: 8426291873 Enrollment ID: I20130904000176 |
| Provider Name | Heather R Grohman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952803165 PECOS PAC ID: 1759628563 Enrollment ID: I20190131001491 |
| Provider Name | Devon Dylla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770306698 PECOS PAC ID: 0648707596 Enrollment ID: I20241217002307 |
Wilson County Memorial Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13857 Us Highway 87 W, La Vernia, TX 78121 Phone: 830-393-1400 |