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Organization
MEDICAL HOME PARTNERS, PA
Active
Organization
MEDICAL HOME PARTNERS, PA
Active
Other names
La Vernia Lighthouse Healtcare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN A CROCKETT M.D. (PRESIDENT CEO)
(830) 253-8116
Entity
Organization
Contact information
Practice address
14114 US HIGHWAY 87 W, LA VERNIA, TX 78121-5881
(830) 253-8116
Mailing address
PO BOX 190, LA VERNIA, TX 78121-0190
(830) 253-8116
(830) 253-8313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J7770
TX
207V00000X
Obstetrics & Gynecology Physician
J7770
TX
Other
Enumeration date
03/06/2007
Last updated
07/12/2007
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