Pilot Point Medical Clinic, P.a.
Organization Active NPI Primary Care Clinic/Center · Pilot Point, TX
NPI 1962424846 · NPPES record last updated Jan 12, 2012
Key facts
- NPI
- 1962424846
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- K9226 (TX)
- Legal business name
- PILOT POINT MEDICAL CLINIC, P.A.
- Practice address
- 1246 S Highway 377
Pilot Point, TX 76258-4375 - Phone
- (940) 686-2254
- Fax
- (940) 686-2830
- NPI assigned
- Jul 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Kenneth Wayne Beresford, M.D.
- Title
- Owner
- Phone
- (940) 686-2254
Practitioners 4
-
Cassie Anne Dennis, FNP-C
-
Joe P Gallo, NP
-
Kimberly M Myers, FNP
-
Jessica Rae Richardson, APRN-C
National Provider Directory
Locations
1246 S Highway 377
Ste 200
Pilot Point, TX 76258
Phone (940) 686-2140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | K9226 | TX | Yes |
Addresses
Primary practice location
1246 S Highway 377
Pilot Point, TX 76258-4375
Mailing address
PO Box 1117
1246 Hwy 377 South Suite 200
Pilot Point, TX 76258-1117
Phone (940) 686-2254
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 045386202 | Medicaid | TX | |
| 0A3440 | Other | TX | MEDICARE GROUP PTAN |
| 8F20689 | Other | TX | MEDICARE INDIV PTAN INDVID NPI |
| 0A3440 | Other | MEDICARE INDIVID PTAN FOR GRP NPI |
Other names
- Kenneth W. Beresford, M.D., P.A.
Other providers in Pilot Point, TX
- Pilot Point Family Eye Care PLLC
- Pilot Point Family Practice Management Inc.
- Pilot Point Healthcare Inc
- Pilot Point Healthcare Operations LLC
- Pilot Point Isd
- Pilot Point Operations, LLC
- Pilot Point Pharmacy LTD.
- Pilot Point Pharmacy LTD.
- Primal Medical Management, LLC
- Ras MGMT LLC
All providers in Pilot Point, 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 Jan 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.