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Contact Information

MED PAVILION PC
220A SW 26TH AVE
MINERAL WELLS, TX76067
 Phone: 940-325-1543
 Fax: 940-325-2679
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MED PAVILION PC

NPI # 1871643007
LBN Legal business name MED PAVILION PC
Authorized official ASHLEY WRIGHT - (CLINIC COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/11/2007
Last updated 02/13/2026 - About 4 months ago
Identifiers
TX License # J4552
TX Medicaid 135150406
TX Medicaid 135150408
Other 80780Y BCBS
TX Other TXB158020 PTAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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