Dr. Fredric Puckett, PLLC
NPI 1073748562ActiveOrganization· Family Medicine· Ennis, TX
Family Medicine in Ennis, Texas, registered in NPPES in May 2009. The authorized official on file is Fredric Clark Puckett, DO, Physician/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1073748562 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 27, 2009 |
| Last updated in NPPES | Jun 13, 2024 |
| Certified by provider | Apr 5, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Pediatrics | 208000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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