| Doc's Interventional Sports Medicine And Primary Care P.l.l.c. | |
|
3322 E Walnut St Ste 112 Pearland TX 77581-4305 | |
| (281) 485-3226 | |
| (281) 485-5520 |
| Full Name | Doc's Interventional Sports Medicine And Primary Care P.l.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 3322 E Walnut St Ste 112, Pearland, Texas |
| Authorized Official Name and Position | Vincent Joseph Mandola (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2814853226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doc's Interventional Sports Medicine And Primary Care P.l.l.c. 3322 E Walnut St Ste 112 Pearland TX 77581-4305 Ph: (281) 485-3226 | Doc's Interventional Sports Medicine And Primary Care P.l.l.c. 3322 E Walnut St Ste 112 Pearland TX 77581-4305 Ph: (281) 485-3226 |
| NPI Number | 1477169076 |
|---|---|
| Provider Enumeration Date | 09/18/2020 |
| Last Update Date | 12/22/2021 |
| Medicare PECOS PAC ID | 9032539531 |
|---|---|
| Medicare Enrollment ID | O20201022002025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477169076 | NPI | - | NPPES |
| 1013352251 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Vincent J Mandola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013352251 PECOS PAC ID: 5092084517 Enrollment ID: I20170627000389 |
| Provider Name | Alexandra Mandola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801383633 PECOS PAC ID: 5193072320 Enrollment ID: I20210820000290 |
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