| Plano Neurology, Pa | |
|
4601 Old Shepard Pl #406 Plano TX 75093-5279 | |
| (972) 867-3535 | |
| (972) 867-3530 |
| Full Name | Plano Neurology, Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4601 Old Shepard Pl, Plano, Texas |
| Authorized Official Name and Position | Geeta Rajan (PRESIDENT) |
| Authorized Official Contact | 9728673535 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Plano Neurology, Pa 4601 Old Shepard Pl #406 Plano TX 75093-5279 Ph: (972) 867-3535 | Plano Neurology, Pa 4601 Old Shepard Pl #406 Plano TX 75093-5279 Ph: (972) 867-3535 |
| NPI Number | 1003884511 |
|---|---|
| Provider Enumeration Date | 03/09/2006 |
| Last Update Date | 11/12/2009 |
| Medicare PECOS PAC ID | 1254301971 |
|---|---|
| Medicare Enrollment ID | O20040729001027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003884511 | NPI | - | NPPES |
| 0004LM | Other | TX | BCBS |
| 036972002 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | K5187 (Texas) | Primary |
| Provider Name | Geeta Rajan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477502235 PECOS PAC ID: 9133199854 Enrollment ID: I20040802000482 |
| Provider Name | Ann Mathew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265951487 PECOS PAC ID: 8325308844 Enrollment ID: I20180201001077 |
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