| Tarrant Neurology Consultants, P.a. | |
|
713 Grainger St Fort Worth TX 76104-7505 | |
| (817) 336-3968 | |
| (817) 336-3917 |
| Full Name | Tarrant Neurology Consultants, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 713 Grainger St, Fort Worth, Texas |
| Authorized Official Name and Position | Krishnababu Chunduri (VICE PRESIDENT) |
| Authorized Official Contact | 8173363968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tarrant Neurology Consultants, P.a. 713 Grainger St Fort Worth TX 76104-7505 Ph: (817) 336-3968 | Tarrant Neurology Consultants, P.a. 713 Grainger St Fort Worth TX 76104-7505 Ph: (817) 336-3968 |
| NPI Number | 1740509843 |
|---|---|
| Provider Enumeration Date | 05/28/2010 |
| Last Update Date | 11/12/2010 |
| Medicare PECOS PAC ID | 3072709369 |
|---|---|
| Medicare Enrollment ID | O20101129000846 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740509843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Krishnababu Chunduri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154316537 PECOS PAC ID: 8325019466 Enrollment ID: I20040803001035 |
| Provider Name | Lincoln F Chin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710920749 PECOS PAC ID: 5294706107 Enrollment ID: I20040804000630 |
| Provider Name | Vinit Mehrotra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205883774 PECOS PAC ID: 6800893330 Enrollment ID: I20061026000122 |
| Provider Name | Yamini P Chennu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548210263 PECOS PAC ID: 5193707982 Enrollment ID: I20081204000898 |
| Provider Name | Hamid H Kadiwala |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275768657 PECOS PAC ID: 3577780758 Enrollment ID: I20140812001113 |
| Provider Name | Mandeep Singh Chahil |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003134131 PECOS PAC ID: 8426369489 Enrollment ID: I20150617000428 |
| Provider Name | Magdala Poon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144541202 PECOS PAC ID: 1052629565 Enrollment ID: I20151002001310 |
| Provider Name | Jennifer L Bruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396295366 PECOS PAC ID: 0446521611 Enrollment ID: I20170807000695 |
| Provider Name | Leila Bostan Shirin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770933434 PECOS PAC ID: 8123306487 Enrollment ID: I20201022000156 |
| Provider Name | Asad Ikram |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992219216 PECOS PAC ID: 0446508881 Enrollment ID: I20230911001215 |
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