| Elite Primary Care Pa | |
|
4004 Medical Pkwy Greenville TX 75401-7854 | |
| (903) 450-1515 | |
| (903) 450-9466 |
| Full Name | Elite Primary Care Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 4004 Medical Pkwy, Greenville, Texas |
| Authorized Official Name and Position | Asif Aziz (PRESIDENT) |
| Authorized Official Contact | 4089100840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Primary Care Pa 4004 Medical Pkwy Greenville TX 75401-7854 Ph: (903) 450-1515 | Elite Primary Care Pa 4004 Medical Pkwy Greenville TX 75401-7854 Ph: (903) 450-1515 |
| NPI Number | 1528389509 |
|---|---|
| Provider Enumeration Date | 06/14/2010 |
| Last Update Date | 12/20/2010 |
| Medicare PECOS PAC ID | 7012100738 |
|---|---|
| Medicare Enrollment ID | O20101026000455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528389509 | NPI | - | NPPES |
| TXB 109980 | Other | TX | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | N2391 (Texas) | Primary |
| Provider Name | Rafiquddin S Rahimi |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1386713329 PECOS PAC ID: 3476573122 Enrollment ID: I20100608000109 |
| Provider Name | Azhar Ahmed Kazi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538357348 PECOS PAC ID: 0143318444 Enrollment ID: I20111025000839 |
| Provider Name | Elsa Varughese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467091611 PECOS PAC ID: 2668877853 Enrollment ID: I20210826001147 |
| Provider Name | Guiselle Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184362964 PECOS PAC ID: 3072989599 Enrollment ID: I20221024002542 |
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