# AE MGEBROFF & DAVID H WATSON PTR

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Yoakum Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124135645
- **Authorized official:** DIANE BRIDGES (PRACTICE MANAGER)
- **Authorized official phone:** (361) 293-2371

## Contact information

- **Practice address:** 402 HUBBARD ST, YOAKUM, TX 77995-4126
- **Practice address phone:** (361) 293-2371
- **Practice address fax:** (361) 741-5162
- **Mailing address:** P O BOX 71, YOAKUM, TX 77995-0071
- **Mailing address phone:** (361) 293-2371
- **Mailing address fax:** (361) 741-5162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 08/06/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 094971101 | — | TX |
| 01 | — | 45D0498918 | CLIA | TN |