| Complete Infectious Diseases Care Associates, Pllc | |
|
11803 South Fwy Ste 202 Burleson TX 76028-7029 | |
| (646) 244-8857 | |
| Not Available |
| Full Name | Complete Infectious Diseases Care Associates, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11803 South Fwy Ste 202, Burleson, Texas |
| Authorized Official Name and Position | Vitaly Golub (OWNER) |
| Authorized Official Contact | 6462448857 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Infectious Diseases Care Associates, Pllc Po Box 1841 Colleyville TX 76034-1841 Ph: () - | Complete Infectious Diseases Care Associates, Pllc 11803 South Fwy Ste 202 Burleson TX 76028-7029 Ph: (646) 244-8857 |
| NPI Number | 1417447012 |
|---|---|
| Provider Enumeration Date | 05/18/2018 |
| Last Update Date | 05/18/2018 |
| Medicare PECOS PAC ID | 8527323955 |
|---|---|
| Medicare Enrollment ID | O20180605002376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417447012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | P6399 (Texas) | Primary |
| Provider Name | Vitaly Golub |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346404993 PECOS PAC ID: 8022294081 Enrollment ID: I20130814000915 |
| Provider Name | Margaret A Stinnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114495629 PECOS PAC ID: 2466788401 Enrollment ID: I20190729001565 |
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