| Grand Medical Clinic | |
|
7510 Lavaerton Wood Ln Richmond TX 77407-3186 | |
| (281) 691-5717 | |
| (866) 717-6261 |
| Full Name | Grand Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 7510 Lavaerton Wood Ln, Richmond, Texas |
| Authorized Official Name and Position | Moiz Ahmed (CEO) |
| Authorized Official Contact | 2816915717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Medical Clinic 7510 Lavaerton Wood Ln Richmond TX 77407-3186 Ph: (281) 691-5717 | Grand Medical Clinic 7510 Lavaerton Wood Ln Richmond TX 77407-3186 Ph: (281) 691-5717 |
| NPI Number | 1881049880 |
|---|---|
| Provider Enumeration Date | 04/27/2016 |
| Last Update Date | 04/27/2016 |
| Medicare PECOS PAC ID | 6305130980 |
|---|---|
| Medicare Enrollment ID | O20160804000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881049880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Moiz Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932359452 PECOS PAC ID: 6507929148 Enrollment ID: I20111014000205 |
| Provider Name | Kruti Patel-konasagar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932714722 PECOS PAC ID: 8820403223 Enrollment ID: I20210217001336 |
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