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1850 Lakepointe Dr Ste 100 Lewisville TX 75057-6443 | |
| (972) 316-3344 | |
| (972) 316-3322 |
| Full Name | |
|---|---|
| Speciality | Pain Medicine |
| Location | 1850 Lakepointe Dr Ste 100, Lewisville, Texas |
| Authorized Official Name and Position | Mohammad J. Tariq (OWNER) |
| Authorized Official Contact | 9723163344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6505 W Park Blvd Ste 306-pmb # 376 Plano TX 75093-6208 Ph: (972) 316-3344 | 1850 Lakepointe Dr Ste 100 Lewisville TX 75057-6443 Ph: (972) 316-3344 |
| NPI Number | 1982637088 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 08/18/2011 |
| Medicare PECOS PAC ID | 7719975515 |
|---|---|
| Medicare Enrollment ID | O20040501000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982637088 | NPI | - | NPPES |
| 720000125 | Other | TX | MEDICARE RAILROAD INDIVID |
| CJ8159 | Other | TX | MEDICARE RAILROAD GROUP |
| 030369501 | Medicaid | TX | |
| P00331394 | Other | TX | MEDICARE RAILROAD INDIVID |
| 184682601 | Medicaid | TX | |
| 184681801 | Medicaid | TX |
| Provider Name | Viktoria S Foote |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124027917 PECOS PAC ID: 6406839315 Enrollment ID: I20040611000054 |
| Provider Name | Mohammad J Tariq |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1639171887 PECOS PAC ID: 3072501873 Enrollment ID: I20040614001624 |
| Provider Name | Dewayne A Handy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285719682 PECOS PAC ID: 1951384007 Enrollment ID: I20040617001697 |
| Provider Name | Tonja Annette Vazquez |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497977995 PECOS PAC ID: 2769423516 Enrollment ID: I20050521000077 |
| Provider Name | Janis M Mays |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932290582 PECOS PAC ID: 4082777628 Enrollment ID: I20090601000583 |
| Provider Name | David M Keelen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790088508 PECOS PAC ID: 9133374580 Enrollment ID: I20130309000085 |
| Provider Name | Lisa M Howse |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215960729 PECOS PAC ID: 1850395732 Enrollment ID: I20130705000549 |
| Provider Name | Rao K Ali |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1558694539 PECOS PAC ID: 8628106432 Enrollment ID: I20170719001904 |
| Provider Name | Saeed Anwar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518939594 PECOS PAC ID: 7113905985 Enrollment ID: I20170724000098 |
| Provider Name | Steve Jay Hong |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1093152639 PECOS PAC ID: 2567716509 Enrollment ID: I20181112000221 |
| Provider Name | Matthew C Darden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881622413 PECOS PAC ID: 6305829862 Enrollment ID: I20210608002845 |
| Provider Name | Zair Arshad Shah |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1205282837 PECOS PAC ID: 0840617783 Enrollment ID: I20210831000757 |
| Provider Name | Bilal Aleem |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659891265 PECOS PAC ID: 5395120729 Enrollment ID: I20220921000150 |
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