Jackson Medical Clinic of Ganado Physician Group – Pediatrics Physician, NPI 1073696357

Pediatrics Physician

Jackson Medical Clinic of Ganado Physician Group is a healthcare provider. based in Ganado, Texas. specializing in Pediatrics Physician. The NPI Number for Jackson Medical Clinic of Ganado Physician Group is 1073696357

Main info

Organization

Name

Jackson Medical Clinic of Ganado Physician Group

NPI

1073696357

Phone

(361) 771-3571

Address

202 S. THIRD STREET

Authorized Official

MARCELLA VANA HENKE ADMINISTRATOR/CEO

Enumeration Date

23 October 2006

Last Update Date

11 September 2025

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience53

Completeness90

Years active:19State licenses:0Digital endpoints

Provider Addresses for Jackson Medical Clinic of Ganado Physician Group

202 S. THIRD STREET
GANADO, TX 779621214
Phone: (361) 771-3571
Fax: (361) 771-3574
Type: Location
Jackson County Hospital, 1013, South Wells Street, Edna, Jackson County, Texas, 77957, United States
EDNA, TX 779574098
Phone: (361) 782-5241
Fax: (361) 782-7495
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77962)

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Reviews

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Frequently asked questions

How do payers reference Jackson Medical Clinic of Ganado Physician Group?

For Jackson Medical Clinic of Ganado Physician Group, use NPI 1073696357 as the unique 10-digit identifier.

Would Jackson Medical Clinic of Ganado Physician Group appear as active to a payer?

You can treat Jackson Medical Clinic of Ganado Physician Group as active for directory purposes; confirm clinical privileges separately.

What clinical focus is listed for Jackson Medical Clinic of Ganado Physician Group?

At a glance, Jackson Medical Clinic of Ganado Physician Group is tied to Pediatrics Physician. Clinical services aligned with this taxonomy classification.

What locale is associated with Jackson Medical Clinic of Ganado Physician Group?

Directory geography for Jackson Medical Clinic of Ganado Physician Group centers on Ganado, Texas.

Does Jackson Medical Clinic of Ganado Physician Group accept insurance?

Insurance participation is not part of the core NPI extract — call the plan or office to confirm.