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NPI Code Detail

MEDICARE: MCLENNAN COUNTY MEDICAL EDUCATION AND RESEARCH FOUNDATION

MEDICARE: MCLENNAN COUNTY MEDICAL EDUCATION AND RESEARCH FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689651440
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCLENNAN COUNTY MEDICAL EDUCATION AND RESEARCH FOUNDATION
Provider Business Mailing Address
First Line : 1600 PROVIDENCE DR
Second Line :
City : WACO
State : TX
Zip : 76707-2261
Country : US
Telephone Number : 254-313-4200
Fax Number : 254-313-4326
Provider Business Practice Location Address
First Line : 1600 PROVIDENCE DR
Second Line :
City : WACO
State : TX
Zip : 76707-2261
Country : US
Telephone Number : 254-313-4200
Fax Number : 254-313-4531
Authorized Official
Title or Position : CFO
Name : MRS. ANNETTE BALLEW
Credential : CPA
Telephone Number : 254-313-4282
Provider Enumeration Date : 12/22/2005
Last Update Date : 07/12/2016

Similar Medicare Providers

1134975634 — DR. MOHAMMAD MAHMOUD MOHAMMAD MD
Practice Location Address:
1600 PROVIDENCE DR
WACO, TX
76707-2261
Practice Phone: 254-313-4200
Practice Fax:
1194713230 — MR. MICHAEL JOHN BORUCKI M.D.
Practice Location Address:
1600 PROVIDENCE DR , FAMILY PRACTICE CENTER
WACO, TX
76707-2261
Practice Phone: 254-750-8200
Practice Fax: 254-750-8383
1740261395 — RANDALL LYNN YORK FNP
Practice Location Address:
1600 PROVIDENCE DR
WACO, TX
76707-2261
Practice Phone: 254-313-4200
Practice Fax: 254-313-4531
1639156425 — DR. WILLIAM M CHOP JR. MD
Practice Location Address:
1600 PROVIDENCE DR
WACO, TX
76707-2261
Practice Phone: 254-313-4200
Practice Fax: 254-313-4531
1164409926 — HEART OF TEXAS COMMUNITY HEALTH CENTER, INC
Practice Location Address:
1600 PROVIDENCE DR
WACO, TX
76707-2261
Practice Phone: 254-313-4200
Practice Fax: 254-313-4531
1225015092 — DR. ROLAND A GOERTZ MD
Practice Location Address:
1600 PROVIDENCE DR
WACO, TX
76707-2261
Practice Phone: 254-750-8200
Practice Fax: 254-750-8326

Directions to “MCLENNAN COUNTY MEDICAL EDUCATION AND RESEARCH FOUNDATION ” Practice Location

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