| Smithson Valley Family Medicine, Llp | |
|
6098 Fm 311 Smithson Valley Family Medicine Spring Branch TX 78070-7253 | |
| (830) 885-5541 | |
| (830) 885-5542 |
| Full Name | Smithson Valley Family Medicine, Llp |
|---|---|
| Speciality | Family Medicine |
| Location | 6098 Fm 311, Spring Branch, Texas |
| Authorized Official Name and Position | Matthew W Nicola (OWNER) |
| Authorized Official Contact | 8308855541 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smithson Valley Family Medicine, Llp 6098 Fm 311 Smithson Valley Family Medicine Spring Branch TX 78070-7253 Ph: (830) 885-5541 | Smithson Valley Family Medicine, Llp 6098 Fm 311 Smithson Valley Family Medicine Spring Branch TX 78070-7253 Ph: (830) 885-5541 |
| NPI Number | 1841322013 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 05/29/2008 |
| Medicare PECOS PAC ID | 3779597927 |
|---|---|
| Medicare Enrollment ID | O20060126000994 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841322013 | NPI | - | NPPES |
| 178787102 | Medicaid | TX | |
| 169864902 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K5049 (Texas) | Primary |
| Provider Name | Matthew W Nicola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124096581 PECOS PAC ID: 9234191248 Enrollment ID: I20041104000250 |
| Provider Name | Stephen J Vreeke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104894468 PECOS PAC ID: 7911911029 Enrollment ID: I20060127000470 |
| Provider Name | David Hoefer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861480592 PECOS PAC ID: 3274546908 Enrollment ID: I20100820000501 |
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