| Gregam Pllc | |
|
4222 Trinity Mills Rd Ste 250 Dallas TX 75287-7655 | |
| (818) 939-2159 | |
| Not Available |
| Full Name | Gregam Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4222 Trinity Mills Rd Ste 250, Dallas, Texas |
| Authorized Official Name and Position | Tracy Teimourian (OWNER) |
| Authorized Official Contact | 8189392159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregam Pllc 4222 Trinity Mills Rd Ste 250 Dallas TX 75287-7655 Ph: () - | Gregam Pllc 4222 Trinity Mills Rd Ste 250 Dallas TX 75287-7655 Ph: (818) 939-2159 |
| NPI Number | 1558070284 |
|---|---|
| Provider Enumeration Date | 11/21/2022 |
| Last Update Date | 11/21/2022 |
| Certification Date | 11/21/2022 |
| Medicare PECOS PAC ID | 6002281565 |
|---|---|
| Medicare Enrollment ID | O20230414000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558070284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kenneth Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639645039 PECOS PAC ID: 1658764568 Enrollment ID: I20220216002057 |
| Provider Name | Tracy Teimourian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639419351 PECOS PAC ID: 8921486408 Enrollment ID: I20220613001497 |
| Provider Name | Winford Amos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477820132 PECOS PAC ID: 2860849940 Enrollment ID: I20231218002956 |
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