| Preferred Hospital Leasing Eldorado, Inc. | |
|
102 N Us Highway 277 Eldorado TX 76936 | |
| (325) 853-2507 | |
| (325) 853-3166 |
| Full Name | Preferred Hospital Leasing Eldorado, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 102 N Us Highway 277, Eldorado, Texas |
| Authorized Official Name and Position | Donald A. Freeman (PRESIDENT) |
| Authorized Official Contact | 4058780202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Hospital Leasing Eldorado, Inc. Po Box V Eldorado TX 76936 Ph: (325) 853-2507 | Preferred Hospital Leasing Eldorado, Inc. 102 N Us Highway 277 Eldorado TX 76936 Ph: (325) 853-2507 |
| NPI Number | 1457405136 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 07/29/2014 |
| Medicare PECOS PAC ID | 5799707618 |
|---|---|
| Medicare Enrollment ID | O20060112000946 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457405136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Walter Gordy Day |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942239207 PECOS PAC ID: 9032188834 Enrollment ID: I20040928001356 |
| Provider Name | Karla D Morrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093708448 PECOS PAC ID: 2365457322 Enrollment ID: I20060213000141 |
| Provider Name | Selina Andrea Burt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942511159 PECOS PAC ID: 6608047519 Enrollment ID: I20110927000059 |
| Provider Name | Kimberly Babb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992252951 PECOS PAC ID: 1456634922 Enrollment ID: I20170207001100 |
| Provider Name | Samuel Clinton Luedecke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043762149 PECOS PAC ID: 9830452929 Enrollment ID: I20180425000657 |
| Provider Name | James Heath Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548729262 PECOS PAC ID: 8022351873 Enrollment ID: I20190517000425 |
| Provider Name | Kristina Jean Prater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093318669 PECOS PAC ID: 4789098401 Enrollment ID: I20210120002572 |
| Provider Name | Marc Mesch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144992082 PECOS PAC ID: 7911395140 Enrollment ID: I20211020003030 |
| Provider Name | Alissa Ann Ussery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275365405 PECOS PAC ID: 9032647946 Enrollment ID: I20250106002730 |
Preferred Hospital Leasing Eldorado Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 N. North Us Highway 277, Eldorado, TX 76936 Phone: 325-853-3137 Fax: 325-853-3677 |