| Bird Dog Wellness | |
|
12242 Queenston Blvd Ste E Houston TX 77095-5353 | |
| (713) 252-3579 | |
| (800) 434-7514 |
| Full Name | Bird Dog Wellness |
|---|---|
| Speciality | Internal Medicine |
| Location | 12242 Queenston Blvd Ste E, Houston, Texas |
| Authorized Official Name and Position | Johnny Gilbert (CEO) |
| Authorized Official Contact | 7132523579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bird Dog Wellness 12242 Queenston Blvd Ste E Houston TX 77095-5353 Ph: (713) 252-3579 | Bird Dog Wellness 12242 Queenston Blvd Ste E Houston TX 77095-5353 Ph: (713) 252-3579 |
| NPI Number | 1124488085 |
|---|---|
| Provider Enumeration Date | 03/03/2016 |
| Last Update Date | 12/11/2020 |
| Medicare PECOS PAC ID | 2062703663 |
|---|---|
| Medicare Enrollment ID | O20170328000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124488085 | NPI | - | NPPES |
| 367518303 | Medicaid | TX | |
| 367518301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 293D00000X | Physiological Laboratory | (* (Not Available)) | Secondary |
| Provider Name | Peter M Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902976483 PECOS PAC ID: 5395631782 Enrollment ID: I20040224000132 |
| Provider Name | Antonio J Ramos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063424992 PECOS PAC ID: 7113917014 Enrollment ID: I20040513000803 |
| Provider Name | Syed V Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184673253 PECOS PAC ID: 5597746008 Enrollment ID: I20040528000803 |
| Provider Name | Anand Balasubramanian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811939606 PECOS PAC ID: 7517949209 Enrollment ID: I20040605000276 |
| Provider Name | Imran Baig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679567838 PECOS PAC ID: 1153304738 Enrollment ID: I20040612000709 |
| Provider Name | Julito P Uy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245262443 PECOS PAC ID: 9830160050 Enrollment ID: I20040803000107 |
| Provider Name | Victor D Trevino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982662029 PECOS PAC ID: 9234178492 Enrollment ID: I20050428000086 |
| Provider Name | Patricia D Salvato |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043218845 PECOS PAC ID: 7315995099 Enrollment ID: I20051011000437 |
| Provider Name | Marco A Vargas |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760582647 PECOS PAC ID: 3274631064 Enrollment ID: I20070601000071 |
| Provider Name | Rosemary O Obudulu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740215029 PECOS PAC ID: 9830289776 Enrollment ID: I20071217000186 |
| Provider Name | Maria Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114116738 PECOS PAC ID: 4587745831 Enrollment ID: I20090107000678 |
| Provider Name | Chi Choi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336182294 PECOS PAC ID: 9537127121 Enrollment ID: I20110121000510 |
| Provider Name | Christine A Contreras |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619133238 PECOS PAC ID: 7113174277 Enrollment ID: I20120823000831 |
| Provider Name | Jeremy Wei-kiang Szeto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386719946 PECOS PAC ID: 0840363222 Enrollment ID: I20130903000180 |
| Provider Name | Anna M Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912940057 PECOS PAC ID: 4880771245 Enrollment ID: I20131022000327 |
| Provider Name | Gloria Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245460625 PECOS PAC ID: 3678705472 Enrollment ID: I20140410000161 |
| Provider Name | Feng Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609281930 PECOS PAC ID: 6709171150 Enrollment ID: I20171010003751 |
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