Preferred Hospital Leasing Eldorado, Inc.
Organization Active NPI Family Medicine Physician · Eldorado, TX
NPI 1457405136 · NPPES record last updated Jul 29, 2014
Key facts
- NPI
- 1457405136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PREFERRED HOSPITAL LEASING ELDORADO, INC.
- Practice address
- 102 N US Highway 277
Eldorado, TX 76936 - Phone
- (325) 853-2507
- Fax
- (325) 853-3166
- NPI assigned
- Jan 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Donald A. Freeman
- Title
- President
- Phone
- (405) 878-0202
Other NPIs with the same Medicare PAC ID 3
Practitioners 7
-
Walter G Day, M.D.
-
Marc Mesch, FNP-C
-
Kristina Jean Prater, FNP-C
-
Clinton W. Ray, P.A.
-
Juanita Morales Sanders, APRN, FNP-BC
-
Darron T Atwood, MD
-
Michael Ross, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060112000946 | TX | Part B Supplier - Clinic/Group Practice | 5799707618 |
Receives reassigned benefits from 7 practitioners Practice locations: Eldorado, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
102 N US Highway 277
Eldorado, TX 76936
Mailing address
PO Box V
Eldorado, TX 76936
Phone (325) 853-2507
Other names
- Schleicher County Medical Center
Other providers in Eldorado, TX
- Jane S Kosub
- Marc Mesch
- James Heath Mitchell
- Preferred Hospital Leasing Eldorado Inc
- Preferred Hospital Leasing Eldorado, Inc.
- Preferred Hospital Leasing Eldorado, Inc.
- Juanita Morales Sanders
- Schleicher County Medical Center
- Schleicher County Volunteer Emergency Medical Service
- Alissa Ann Ussery
All providers in Eldorado, 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 Jul 29, 2014. 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.