Melencio Francisco Juan, M.D.
Individual provider Active NPI Family Medicine Physician · Stanton, TX
NPI 1942386248 · NPPES record last updated Dec 2, 2020
Key facts
- NPI
- 1942386248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- K8242 (TX)
- Practice address
- 600 East Interstate 20
Suite D 101
Stanton, TX 79782 - Phone
- (432) 607-3250
- Fax
- (432) 607-3681
- NPI assigned
- Oct 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040207000033 | TX | Practitioner - Family Practice | 5890688295 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20910 | OK | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin County Hospital District | Current |
Accepting new patients | |
| Martin County Hospital District | Current |
Accepting new patients | |
| D&S Residential Services, LP | Past | Accepting new patients | |
| Healdton Municipal Hospital (SNF) | Past | Accepting new patients |
Locations
600 E Interstate 20
Ste D
Stanton, TX 79782
Phone (432) 607-3250
600 E Interstate 20
Stanton, TX 79782
Phone (432) 607-3200
Interoperability endpoints
- 960300mj@mchd.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | K8242 | TX | Yes |
Addresses
Primary practice location
600 East Interstate 20
Suite D 101
Stanton, TX 79782
Mailing address
PO Box 640
Stanton, TX 79782-0640
Phone (432) 607-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037569305 | Medicaid | TX | |
| 8W6600 | Other | TX | BCBS OF TX |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | 960300MJ@mchd.cernerdirect.com | Direct |
Other providers in Stanton, TX
- Commissioners Court of Martin County
- Desiree Davis
- Stephanie Danielle De Hoyos
- Holly Elizabeth Evans
- Five Point Home Care LLC
- Kyle Dean Kendall
- Colton Kidd
- Edward Maurice Lopez
- Martin County Hospital District
- Martin County Hospital District
All providers in Stanton, 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 Dec 2, 2020. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.