Jim Ned Premier Health & Med Spa, PLLC
Organization Active NPI Primary Care Clinic/Center · Tuscola, TX
NPI 1144928813 · NPPES record last updated Jul 21, 2023
Key facts
- NPI
- 1144928813
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- JIM NED PREMIER HEALTH & MED SPA, PLLC
- Practice address
- 731 Graham St.
Tuscola, TX 79562-7956 - Phone
- (432) 557-6694
- NPI assigned
- Feb 21, 2023
- Organization subpart
- No
Authorized official
- Name
- Rebecca Garcia
- Title
- Owner
- Phone
- (325) 554-7072
Practitioners 1
-
Rebecca Joanne Garcia, MSN, APRN, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2278198 | Jim Ned Premier Health & Med Spa | Certificate of waiver | Mar 13, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230710001527 | TX | Part B Supplier - Clinic/Group Practice | 0446619357 |
Receives reassigned benefits from 1 practitioner Practice locations: Tuscola, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
731 Graham St.
Tuscola, TX 79562-7956
Mailing address
731 Graham St.
Tuscola, TX 79562-3724
Phone (325) 554-7072
Other providers in Tuscola, TX
- Hannah Grace Flanagan
- Rebecca Joanne Garcia
- Cassandra Gee
- Cali Hellums
- Donna R Hunt
- Jim Ned Public Schools
- Maxi Lang Kirk
- Carla Sue Lewis
- Brandi R Loya
- Amber Lujan
All providers in Tuscola, TX · Primary Care Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.