| Citywide Housecalls, Llc | |
|
8035 E R L Thornton Fwy Ste 424 Dallas TX 75228-7069 | |
| (972) 808-7541 | |
| (888) 227-0925 |
| Full Name | Citywide Housecalls, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8035 E R L Thornton Fwy Ste 424, Dallas, Texas |
| Authorized Official Name and Position | David Coria (OWNER) |
| Authorized Official Contact | 9729045230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citywide Housecalls, Llc 8035 E R L Thornton Fwy Ste 424 Dallas TX 75228-7069 Ph: (972) 808-7541 | Citywide Housecalls, Llc 8035 E R L Thornton Fwy Ste 424 Dallas TX 75228-7069 Ph: (972) 808-7541 |
| NPI Number | 1679983662 |
|---|---|
| Provider Enumeration Date | 04/30/2014 |
| Last Update Date | 06/06/2023 |
| Medicare PECOS PAC ID | 2961626569 |
|---|---|
| Medicare Enrollment ID | O20140623001654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679983662 | NPI | - | NPPES |
| Provider Name | Dale J Bradley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588607428 PECOS PAC ID: 6608789250 Enrollment ID: I20031110000378 |
| Provider Name | Jane U Mokwenye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619447901 PECOS PAC ID: 9830435478 Enrollment ID: I20190117003704 |
| Provider Name | Ashwin Venkataraman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083095061 PECOS PAC ID: 2163718818 Enrollment ID: I20210707000392 |
| Provider Name | Koi-lucie Abbott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821740309 PECOS PAC ID: 0648654764 Enrollment ID: I20220908001090 |
| Provider Name | Katrina Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710600135 PECOS PAC ID: 5395193353 Enrollment ID: I20231130003612 |
| Provider Name | Patricia J Ezzard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770354342 PECOS PAC ID: 3678911955 Enrollment ID: I20240405000426 |
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