| Southern Horizon Healthcare, Pllc | |
|
2014 Justin Rd Suite 104 Highland Village TX 75077-7161 | |
| (469) 645-0200 | |
| (469) 637-0000 |
| Full Name | Southern Horizon Healthcare, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2014 Justin Rd, Highland Village, Texas |
| Authorized Official Name and Position | Jennifer M Bontreger (CO-OWNER) |
| Authorized Official Contact | 4696450200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Horizon Healthcare, Pllc 2014 Justin Rd Suite 104 Highland Village TX 75077-7161 Ph: (469) 645-0200 | Southern Horizon Healthcare, Pllc 2014 Justin Rd Suite 104 Highland Village TX 75077-7161 Ph: (469) 645-0200 |
| NPI Number | 1649691429 |
|---|---|
| Provider Enumeration Date | 12/23/2013 |
| Last Update Date | 02/01/2014 |
| Medicare PECOS PAC ID | 3072739796 |
|---|---|
| Medicare Enrollment ID | O20140731002875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649691429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jennifer Bontreger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679516652 PECOS PAC ID: 4688699531 Enrollment ID: I20120110000193 |
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