Academic Medical Associates Pllc | |
2021 N Macarthur Blvd Ste 435 Irving TX 75061-2219 | |
(972) 445-9515 | |
(972) 445-9414 |
Full Name | Academic Medical Associates Pllc |
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Speciality | Internal Medicine |
Location | 2021 N Macarthur Blvd Ste 435, Irving, Texas |
Authorized Official Name and Position | Amy Goliszek (COO) |
Authorized Official Contact | 2145062617 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Academic Medical Associates Pllc 9330 Lbj Fwy Ste 800 Dallas TX 75243-4310 Ph: (972) 792-5700 | Academic Medical Associates Pllc 2021 N Macarthur Blvd Ste 435 Irving TX 75061-2219 Ph: (972) 445-9515 |
NPI Number | 1265091425 |
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Provider Enumeration Date | 06/11/2019 |
Last Update Date | 10/06/2020 |
Medicare PECOS PAC ID | 3971831439 |
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Medicare Enrollment ID | O20190821002273 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265091425 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Stephen E Pratt |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1831186030 PECOS PAC ID: 8325039837 Enrollment ID: I20140513000144 |
Provider Name | Janani Krishnaswami |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1154643872 PECOS PAC ID: 9032364252 Enrollment ID: I20160823001916 |
Provider Name | Laquisha Colby |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588130926 PECOS PAC ID: 0941627582 Enrollment ID: I20200827003621 |
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