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Member Type
Broker
Contact Information
Address & Residence
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Basic Information
Contact Information
Clinic Address
Patients
| Patient Name | Account Number | Member ID | Date of Birth | Home Phone | Plan Status | |
|---|---|---|---|---|---|---|
| Emma Bold | 51894417 | 2547895 | 1/17/1985 | (915) 216-8365 | emma@intenso.com | Active |
| Ana Crown | 51894447 | 2547896 | 10/25/1986 | (915) 254-9875 | ana.cf@limtel.com | Active |
| Robert Doe | 51894455 | 7895478 | 8/12/1990 | (915) 965-4789 | robert@benko.com | Active |
| John Miller | 51894434 | 9854789 | 11/18/1995 | (915) 317-8957 | miller@mapple.com | Inactive |
| Max Smith | 51895847 | 3685478 | 2/17/1998 | (915) 325-1458 | max@kt.com | Active |
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Jason Doe Active
35 Years (10/25/1989)
|Gender:
Male
|
Marital
Status:
Married
|
Dependent
Of:
Alex Jenning
Member
ID:
721533
Optum RX
Number:
1851351157445601
Contact Information
Home
Phone:
(915) 216-8365
Cell
Phone:
(915) 216-8745
Email:
jason.doe@gmail.com
Alt
Phone:
(915) 854-5478
Work
Phone:
(915) 854-5847
Email:
jason.doe@gmail.com
Address & Residence
Address:
13023 Aberdare Dr, EI
Paso, TX, 79928
Residence
Type:
Home
Apartment
#:
2548
Plan Details
Type:
Comprehensive Gold Dep
Infornation:
Effective Date:
3/1/2018
Infornation:
End Date:
10/31/2024