| Cooper Family Practice Pllc | |
|
3600 S Cooper St Ste 120 Arlington TX 76015-3406 | |
| (817) 987-1414 | |
| (817) 987-1425 |
| Full Name | Cooper Family Practice Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3600 S Cooper St Ste 120, Arlington, Texas |
| Authorized Official Name and Position | Durga Prasad Mekala (OWNER) |
| Authorized Official Contact | 8178990721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooper Family Practice Pllc 945 Deforest Rd Coppell TX 75019-2740 Ph: (469) 442-9132 | Cooper Family Practice Pllc 3600 S Cooper St Ste 120 Arlington TX 76015-3406 Ph: (817) 987-1414 |
| NPI Number | 1376249284 |
|---|---|
| Provider Enumeration Date | 02/02/2023 |
| Last Update Date | 01/11/2024 |
| Medicare PECOS PAC ID | 0547627457 |
|---|---|
| Medicare Enrollment ID | O20230608001785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376249284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| Provider Name | Durga Prasad Mekala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235340290 PECOS PAC ID: 9931375334 Enrollment ID: I20120106000384 |
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