| Excel Physicians Group Pllc | |
|
4100 Heritage Ave Suite 102 Grapevine TX 76051-5714 | |
| (817) 283-1112 | |
| (817) 283-1116 |
| Full Name | Excel Physicians Group Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4100 Heritage Ave, Grapevine, Texas |
| Authorized Official Name and Position | Monalisa Mitra (OWNER) |
| Authorized Official Contact | 2146418578 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Excel Physicians Group Pllc 4100 Heritage Ave Suite 102 Grapevine TX 76051-5714 Ph: (817) 283-1112 | Excel Physicians Group Pllc 4100 Heritage Ave Suite 102 Grapevine TX 76051-5714 Ph: (817) 283-1112 |
| NPI Number | 1558706119 |
|---|---|
| Provider Enumeration Date | 05/08/2013 |
| Last Update Date | 03/04/2014 |
| Medicare PECOS PAC ID | 4385884246 |
|---|---|
| Medicare Enrollment ID | O20130717000570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558706119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M4363 (Texas) | Primary |
| Provider Name | Monalisa M Mitra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710097456 PECOS PAC ID: 0042211385 Enrollment ID: I20070129000709 |
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