| Texas Family Doctor, P.a. | |
|
951 E Loop 304 Crockett TX 75835-5403 | |
| (936) 655-0500 | |
| Not Available |
| Full Name | Texas Family Doctor, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 951 E Loop 304, Crockett, Texas |
| Authorized Official Name and Position | Michael Reilly Mcleod (OWNER) |
| Authorized Official Contact | 9366550500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Family Doctor, P.a. Po Box 627 Crockett TX 75835-0627 Ph: (936) 655-0500 | Texas Family Doctor, P.a. 951 E Loop 304 Crockett TX 75835-5403 Ph: (936) 655-0500 |
| NPI Number | 1629714860 |
|---|---|
| Provider Enumeration Date | 05/10/2022 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 3577940923 |
|---|---|
| Medicare Enrollment ID | O20220524002364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629714860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Reil Mcleod |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104897750 PECOS PAC ID: 7719968056 Enrollment ID: I20040525000291 |
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