| Desoto Healthcare Clinic Llc | |
|
1221 W Airport Fwy Ste 209 Irving TX 75062-6209 | |
| (214) 777-2703 | |
| (817) 865-1530 |
| Full Name | Desoto Healthcare Clinic Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1221 W Airport Fwy Ste 209, Irving, Texas |
| Authorized Official Name and Position | Naureen Salim (OWNER) |
| Authorized Official Contact | 6825585993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desoto Healthcare Clinic Llc 1221 W Airport Fwy Ste 209 Irving TX 75062-6209 Ph: (214) 777-2703 | Desoto Healthcare Clinic Llc 1221 W Airport Fwy Ste 209 Irving TX 75062-6209 Ph: (214) 777-2703 |
| NPI Number | 1225707342 |
|---|---|
| Provider Enumeration Date | 09/10/2021 |
| Last Update Date | 07/19/2024 |
| Medicare PECOS PAC ID | 1153719414 |
|---|---|
| Medicare Enrollment ID | O20211020000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225707342 | NPI | - | NPPES |
| 1881281905 | Other | TX | PRIMARY CARE |
| Provider Name | Eugene Jonathan Wyszynski |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1760431845 PECOS PAC ID: 0143207100 Enrollment ID: I20040707000883 |
| Provider Name | Chris Gerald Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760813547 PECOS PAC ID: 3870884430 Enrollment ID: I20160629001065 |
| Provider Name | Edward Galvan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891115614 PECOS PAC ID: 0749556900 Enrollment ID: I20171017000447 |
| Provider Name | Naureen Salim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881281905 PECOS PAC ID: 0143618413 Enrollment ID: I20211020000440 |
| Provider Name | Muhammad Aftkhar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386392249 PECOS PAC ID: 7911392055 Enrollment ID: I20220328000873 |
| Provider Name | Madelin Perez Antela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124771803 PECOS PAC ID: 6800267279 Enrollment ID: I20230123000474 |
| Provider Name | Roselio Perez Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043780513 PECOS PAC ID: 0941699755 Enrollment ID: I20230816001878 |
| Provider Name | Njukam Ngufac Loveline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508114489 PECOS PAC ID: 7315300415 Enrollment ID: I20230822003185 |
| Provider Name | Christina Lynn Helms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053199935 PECOS PAC ID: 8224485099 Enrollment ID: I20231115003980 |
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