| Gonnalagadda Pllc | |
|
5140 Legendary Dr Ste 100 Frisco TX 75034-9042 | |
| (469) 850-1432 | |
| Not Available |
| Full Name | Gonnalagadda Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5140 Legendary Dr Ste 100, Frisco, Texas |
| Authorized Official Name and Position | Sreeram Gonnalagadda (OWNER/MANAGER) |
| Authorized Official Contact | 4698501432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gonnalagadda Pllc 5140 Legendary Dr Ste 100 Frisco TX 75034-9042 Ph: (469) 850-1432 | Gonnalagadda Pllc 5140 Legendary Dr Ste 100 Frisco TX 75034-9042 Ph: (469) 850-1432 |
| NPI Number | 1851774079 |
|---|---|
| Provider Enumeration Date | 07/07/2015 |
| Last Update Date | 10/25/2024 |
| Medicare PECOS PAC ID | 0941515522 |
|---|---|
| Medicare Enrollment ID | O20150811004646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851774079 | NPI | - | NPPES |
| 3566481 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | Q2446 (Texas) | Primary |
| Provider Name | Sreeram Gonnalagadda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568520187 PECOS PAC ID: 7911067228 Enrollment ID: I20150813010131 |
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