| Blue Lotus Medical Group Llc | |
|
7600 Chevy Chase Dr Ste 300 Austin TX 78752-1599 | |
| (817) 910-6711 | |
| (800) 915-0474 |
| Full Name | Blue Lotus Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7600 Chevy Chase Dr Ste 300, Austin, Texas |
| Authorized Official Name and Position | Shawn Matheson (COO) |
| Authorized Official Contact | 2819281130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Lotus Medical Group Llc 4201 Cypress Creek Pkwy Ste 536 Houston TX 77068-3458 Ph: (817) 910-6711 | Blue Lotus Medical Group Llc 7600 Chevy Chase Dr Ste 300 Austin TX 78752-1599 Ph: (817) 910-6711 |
| NPI Number | 1578309852 |
|---|---|
| Provider Enumeration Date | 07/05/2024 |
| Last Update Date | 11/15/2024 |
| Medicare PECOS PAC ID | 7113458522 |
|---|---|
| Medicare Enrollment ID | O20241009000460 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578309852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Secondary |
| Provider Name | Hermanjeet S Grewal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871881300 PECOS PAC ID: 3678799004 Enrollment ID: I20141216000943 |
| Provider Name | Ariel Beckey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720745425 PECOS PAC ID: 0840630901 Enrollment ID: I20241028003836 |
| Provider Name | Johnny Ray Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336824721 PECOS PAC ID: 1759516388 Enrollment ID: I20241115004041 |
Harold D Lewis Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 West William Cannon Drive, Suite 123, Austin, TX 78745 Phone: 512-444-2661 Fax: 512-444-2720 | |
Julie Graves Moy Md Mph Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8127 Mesa Dr, B206-54, Austin, TX 78759 Phone: 512-689-8001 | |
Edie E. Shulman M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11673 Jollyville Rd., Suite B-101, Austin, TX 78759 Phone: 512-339-1535 Fax: 512-339-1526 | |
Doctx3 Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 W Slaughter Ln, Suite 300, Austin, TX 78748 Phone: 469-277-8253 |