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Organization
PARKSIDE FAMILY CLINIC, PA
Active
Organization
PARKSIDE FAMILY CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R MCLEOD M.D. (MEDICAL DIRECTOR/OWNER)
(361) 275-2800
Entity
Organization
Contact information
Practice address
1109 E BROADWAY ST, CUERO, TX 77954-2108
(361) 275-2800
(361) 275-8791
Mailing address
1109 E BROADWAY ST, CUERO, TX 77954-2108
(361) 275-2800
(361) 275-8791
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164281101
—
TX
05
—
164281102
—
TX
05
—
179346501
—
TX
05
—
179346502
—
TX
05
—
179346503
—
TX
01
—
DB6498
RR MCR
TX
Enumeration date
01/30/2006
Last updated
02/14/2011
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