Chandan Mazumder, MD | |
1900 W Wall St Ste C, Midland, TX 79701-6568 | |
(432) 221-2500 | |
(432) 687-1914 |
Full Name | Chandan Mazumder |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1900 W Wall St Ste C, Midland, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093928913 | NPI | - | NPPES |
279640600 | Medicaid | FL | |
305512101 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ME 98432 (Florida) | Secondary |
208000000X | Pediatrics | P3771 (Texas) | Primary |
Entity Name | Premier Family Care I, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275522864 PECOS PAC ID: 2567351372 Enrollment ID: O20040311000343 |
Entity Name | Midland Community Healthcare Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235225087 PECOS PAC ID: 0345230975 Enrollment ID: O20040515000364 |
Mailing Address | Practice Location Address |
---|---|
Chandan Mazumder, MD 4214 Andrews Hwy Ste 240, Midland, TX 79703-4817 Ph: (432) 686-6605 | Chandan Mazumder, MD 1900 W Wall St Ste C, Midland, TX 79701-6568 Ph: (432) 221-2500 |
Mohammed Hussein Nasser Aljarwi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4214 Andrews Hwy Ste 102, Midland, TX 79703 Phone: 432-221-5580 Fax: 432-221-5585 | |
Dr. Wellington F Ballesteros, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 Delano Ave, Midland, TX 79701 Phone: 432-697-4747 Fax: 432-699-3813 | |
Nidhi Girishchandra Shah, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4214 Andrews Hwy Ste 310, Midland, TX 79703 Phone: 432-697-4747 Fax: 432-699-3813 | |
Jennifer Blackerby, Pediatrics Medicare: Medicare Enrolled Practice Location: 3600 N Garfield St, Midland, TX 79705 Phone: 432-620-1120 | |
Kranthi Nandan Seelaboyina, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 316 Secor St, Midland, TX 79701 Phone: 432-620-1111 Fax: 432-620-1112 | |
Megan Breanne Rossman, PA-C Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 302 Secor St, Midland, TX 79701 Phone: 432-685-5029 |