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NPI Code Detail

MEDICARE: BAY AREA TRANSITIONAL CLINIC PLLC

MEDICARE: BAY AREA TRANSITIONAL CLINIC PLLC
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
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1073987111
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAY AREA TRANSITIONAL CLINIC PLLC
Provider Business Mailing Address
First Line : 6608 GULF FWY STE 100
Second Line :
City : LA MARQUE
State : TX
Zip : 77568-4095
Country : US
Telephone Number : 409-655-2770
Fax Number : 844-234-6011
Provider Business Practice Location Address
First Line : 6608 GULF FWY STE 100
Second Line :
City : LA MARQUE
State : TX
Zip : 77568-4095
Country : US
Telephone Number : 409-655-2770
Fax Number : 844-234-6011
Authorized Official
Title or Position : PHYSICIAN
Name : DOROTHY F MERRITT
Credential : M.D.
Telephone Number : 409-655-2770
Provider Enumeration Date : 11/29/2015
Last Update Date : 02/09/2023

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Directions to “BAY AREA TRANSITIONAL CLINIC PLLC ” Practice Location

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