Merced Family Health Clinic

Organization Active NPI General Practice Physician · Palmview, TX

NPI 1659974657 · NPPES record last updated Dec 15, 2020

Key facts

NPI
1659974657
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
MERCED FAMILY HEALTH CLINIC
Practice address
202 Palmview Dr Ste 1
Palmview, TX 78572-9394
Phone
(956) 225-2625
Fax
(956) 598-6069
NPI assigned
Nov 20, 2020
Organization subpart
No

Authorized official

Name
Mr. Juan R Llanes, APRN,FNP-BC
Title
Owner
Phone
(956) 225-2625

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2224091Merced Family Health Clinic
202 Palmview Drive, Suite 1, Palmview, TX 78572
Certificate of waiverMay 10, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210715002260 TX Part B Supplier - Clinic/Group Practice 3870908122 Receives reassigned benefits from 1 practitioner
Practice locations: Palmview, TX

National Provider Directory

Locations

202 Palmview Dr
Ste 1
Palmview, TX 78572

202 Palmview Dr
Ste A
Palmview, TX 78572
Phone (956) 585-0022

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

202 Palmview Dr Ste 1
Palmview, TX 78572-9394

Mailing address

PO Box 3371
Mission, TX 78573-0057
Phone (956) 225-2625

Other identifiers

IdentifierTypeStateIssuer
1306843347OtherTXJRL NPI
1391708-22MedicaidTX
1639137193OtherTXDOC NPI

Other providers in Palmview, TX

All providers in Palmview, TX · General Practice Physician in Texas

Sources for this page

Verify at the official NPI Registry.