| Diverse Community Healthcare Pllc | |
|
21898 Fm 1314 Rd Ste B Porter TX 77365-7061 | |
| (281) 354-2417 | |
| (281) 786-0267 |
| Full Name | Diverse Community Healthcare Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21898 Fm 1314 Rd Ste B, Porter, Texas |
| Authorized Official Name and Position | Randall Roland (OWNER/PROVIDER) |
| Authorized Official Contact | 2813542417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diverse Community Healthcare Pllc 21898 Fm 1314 Rd Ste B Porter TX 77365-7061 Ph: (281) 354-2417 | Diverse Community Healthcare Pllc 21898 Fm 1314 Rd Ste B Porter TX 77365-7061 Ph: (281) 354-2417 |
| NPI Number | 1295291367 |
|---|---|
| Provider Enumeration Date | 02/14/2019 |
| Last Update Date | 02/16/2019 |
| Medicare PECOS PAC ID | 7911248646 |
|---|---|
| Medicare Enrollment ID | O20190408000732 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295291367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gayana Grigoryan Roland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225464860 PECOS PAC ID: 0244508869 Enrollment ID: I20180604001485 |
| Provider Name | Randall K Roland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275912354 PECOS PAC ID: 8820347552 Enrollment ID: I20180814001302 |
| Provider Name | Charles Amoafo Amelemah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356788178 PECOS PAC ID: 3375831746 Enrollment ID: I20190815002177 |
Porter Medical Center Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24540 Fm 1314 Rd, Porter, TX 77365 Phone: 832-326-8032 Fax: 281-354-8815 | |
Mda Diversified Enterprises Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 23527 Fm 1314 Rd Ste E, Porter, TX 77365 Phone: 281-381-6190 | |
Unity Hospitalist Group Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 21693 Fm 1314 Rd Ste 400, Porter, TX 77365 Phone: 281-354-2417 Fax: 281-786-0267 | |
Myway Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20711 Lavone Dr, Porter, TX 77365 Phone: 512-956-9929 |