Great Health Aftx PC
Organization Active NPI Family Medicine Physician · Stamford, TX
NPI 1174384259 · NPPES record last updated Jan 28, 2025
Key facts
- NPI
- 1174384259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- GREAT HEALTH AFTX PC
- Practice address
- 1003 Columbia St
Stamford, TX 79553-6825 - Phone
- (212) 201-1252
- NPI assigned
- Jan 17, 2024
- Organization subpart
- No
Authorized official
- Name
- Aron Feldman
- Title
- Owner
- Phone
- (248) 514-9356
Practitioners 6
-
Wendy Vandyke, GNP-BC
-
Willie Benjamin Ballou, NP-C
-
Sonika Randev, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240208001109 | TX | Part B Supplier - Clinic/Group Practice | 5193168938 |
Receives reassigned benefits from 6 practitioners Practice locations: Stamford, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1003 Columbia St
Stamford, TX 79553-6825
Mailing address
407 Willoughby Ave
Brooklyn, NY 11205-4590
Other providers in Stamford, TX
- Carpenter SNF Director Services, PLLC
- Jeanne Kay Cason
- Laura Dokupil
- Lauten Dawn Escobedo
- Frio Hospital District
- Haskell County Hospital
- Camilette Huddleston
- Jones County Regional Healthcare System
- Jones County Regional Healthcare System
- Jones County Regional Healthcare System
All providers in Stamford, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.