| West Texas Wellness Clinic | |
|
601 East 7th Street Odessa TX 79761 | |
| (432) 582-0300 | |
| (432) 582-0306 |
| Full Name | West Texas Wellness Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 601 East 7th Street, Odessa, Texas |
| Authorized Official Name and Position | John Thaddeus Garcia (OWNER) |
| Authorized Official Contact | 4325820300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Texas Wellness Clinic 601 East 7th Street Odessa TX 79761 Ph: (432) 582-0300 | West Texas Wellness Clinic 601 East 7th Street Odessa TX 79761 Ph: (432) 582-0300 |
| NPI Number | 1568640365 |
|---|---|
| Provider Enumeration Date | 02/04/2008 |
| Last Update Date | 07/10/2008 |
| Medicare PECOS PAC ID | 6406935964 |
|---|---|
| Medicare Enrollment ID | O20080508000550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568640365 | NPI | - | NPPES |
| 00Y994 | Other | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J6447 (Texas) | Primary |
| Provider Name | John T Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275683484 PECOS PAC ID: 3870672330 Enrollment ID: I20080508000545 |
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