| Prism Health North Texas | |
|
3900 Junius St Ste 300 Dallas TX 75246-1602 | |
| (214) 521-5191 | |
| (214) 623-6806 |
| Full Name | Prism Health North Texas |
|---|---|
| Speciality | Clinic/Center |
| Location | 3900 Junius St Ste 300, Dallas, Texas |
| Authorized Official Name and Position | John Thomas Carlo (CEO) |
| Authorized Official Contact | 2145215191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prism Health North Texas 3900 Junius St Ste 300 Dallas TX 75246-1602 Ph: (214) 521-5191 | Prism Health North Texas 3900 Junius St Ste 300 Dallas TX 75246-1602 Ph: (214) 521-5191 |
| NPI Number | 1609852813 |
|---|---|
| Provider Enumeration Date | 12/20/2005 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Medicare PECOS PAC ID | 7719940774 |
|---|---|
| Medicare Enrollment ID | O20041110000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609852813 | NPI | - | NPPES |
| Provider Name | David M Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801850201 PECOS PAC ID: 8527022714 Enrollment ID: I20041117000568 |
| Provider Name | Jennifer K Klein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669517033 PECOS PAC ID: 6305892704 Enrollment ID: I20050329000921 |
| Provider Name | Rasha M Ghurani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699741785 PECOS PAC ID: 8123058880 Enrollment ID: I20050812000938 |
| Provider Name | Deborah Gail Morris-harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477537843 PECOS PAC ID: 1850295114 Enrollment ID: I20060728000154 |
| Provider Name | Robert Douglas Hardy |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588623615 PECOS PAC ID: 3678630209 Enrollment ID: I20090325000537 |
| Provider Name | Donald A Graneto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669672481 PECOS PAC ID: 8224224282 Enrollment ID: I20101202000349 |
| Provider Name | Rachel Rivera |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1437359346 PECOS PAC ID: 8820247380 Enrollment ID: I20120927000621 |
| Provider Name | Elizabeth Race |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568424596 PECOS PAC ID: 1557510989 Enrollment ID: I20120928000614 |
| Provider Name | Charmeka L C Lipscomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962751305 PECOS PAC ID: 0648421107 Enrollment ID: I20121108000655 |
| Provider Name | Vanessa L Bludau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063763670 PECOS PAC ID: 4486890704 Enrollment ID: I20130411000147 |
| Provider Name | Gary Sinclair |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891757613 PECOS PAC ID: 4880875038 Enrollment ID: I20130729000800 |
| Provider Name | Mary R Mclaud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659793966 PECOS PAC ID: 7719204056 Enrollment ID: I20150325000203 |
| Provider Name | William A Hays |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518900554 PECOS PAC ID: 7113234535 Enrollment ID: I20180508000777 |
| Provider Name | Amy M Barrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881177822 PECOS PAC ID: 1153669908 Enrollment ID: I20190220003139 |
| Provider Name | Emilija Rosenthal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710485479 PECOS PAC ID: 3072852813 Enrollment ID: I20190222000689 |
| Provider Name | Kristina Kay Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609342435 PECOS PAC ID: 9830430685 Enrollment ID: I20190404002467 |
| Provider Name | Taylor G Schmidt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386185593 PECOS PAC ID: 9739584699 Enrollment ID: I20210816003975 |
| Provider Name | Richard W. Ornberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255922936 PECOS PAC ID: 7113300773 Enrollment ID: I20220815000396 |
| Provider Name | Raymond Castilleja |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225459530 PECOS PAC ID: 8325413164 Enrollment ID: I20230410002415 |
| Provider Name | Natalie Marie Low |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619432853 PECOS PAC ID: 0840665147 Enrollment ID: I20230418001405 |
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