| Whitney Family Medicine | |
|
1314 N Brazos St Whitney TX 76692-2010 | |
| (254) 694-3621 | |
| (254) 694-7436 |
| Full Name | Whitney Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1314 N Brazos St, Whitney, Texas |
| Authorized Official Name and Position | Randall Dale Henderson (MANAGING MEMBER) |
| Authorized Official Contact | 2546943621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whitney Family Medicine Po Box 2177 Whitney TX 76692-5177 Ph: (254) 694-3621 | Whitney Family Medicine 1314 N Brazos St Whitney TX 76692-2010 Ph: (254) 694-3621 |
| NPI Number | 1366862310 |
|---|---|
| Provider Enumeration Date | 04/17/2014 |
| Last Update Date | 04/24/2014 |
| Medicare PECOS PAC ID | 3274759303 |
|---|---|
| Medicare Enrollment ID | O20140728000475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366862310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L1340 (Texas) | Primary |
| Provider Name | Randall D Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700879848 PECOS PAC ID: 4486645215 Enrollment ID: I20110308001010 |
| Provider Name | Jennifer P Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346632197 PECOS PAC ID: 2264742881 Enrollment ID: I20151112000261 |
| Provider Name | Kendra Breann Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376194571 PECOS PAC ID: 2264856889 Enrollment ID: I20200715002924 |
| Provider Name | Mary Angela Casanova |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063629335 PECOS PAC ID: 3678998226 Enrollment ID: I20200730000992 |
| Provider Name | Leslie Ann-sikes Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003405945 PECOS PAC ID: 1254329691 Enrollment ID: I20210222002080 |
Interstate Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 N Bosque St, Whitney, TX 76692 Phone: 254-221-4342 Fax: 254-221-7051 | |
Lake Whitney Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N San Jacinto St, Whitney, TX 76692 Phone: 954-415-3599 Fax: 800-497-3983 | |
Lakeside Healthcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1512 North Brazos, Whitney, TX 76692 Phone: 254-694-6871 Fax: 254-694-6876 | |
Lake Whitney Physicians Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 E Jefferson Ave, Whitney, TX 76692 Phone: 254-694-2221 Fax: 254-694-9978 | |
Clayton Pickering Do, Pa. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 E Jefferson Ave, Whitney, TX 76692 Phone: 254-694-2221 Fax: 254-694-9978 | |
Rinity Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N San Jacinto St, Whitney, TX 76692 Phone: 972-470-0363 | |
Lake Whitney Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 E Jefferson Ave, Whitney, TX 76692 Phone: 254-694-2221 Fax: 254-694-9978 |