Healthy Living Primary Care Pllc | |
200 S Rivershire Dr Ste 200 Conroe TX 77304-3485 | |
(936) 234-5400 | |
(888) 714-0097 |
Full Name | Healthy Living Primary Care Pllc |
---|---|
Speciality | Internal Medicine |
Location | 200 S Rivershire Dr Ste 200, Conroe, Texas |
Authorized Official Name and Position | Tapasya Mandalapu (MANAGING DIRECTOR) |
Authorized Official Contact | 7864496644 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Healthy Living Primary Care Pllc 200 S Rivershire Dr Ste 200 Conroe TX 77304-3485 Ph: (936) 234-5400 | Healthy Living Primary Care Pllc 200 S Rivershire Dr Ste 200 Conroe TX 77304-3485 Ph: (936) 234-5400 |
NPI Number | 1114547486 |
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Provider Enumeration Date | 04/16/2020 |
Last Update Date | 07/26/2022 |
Medicare PECOS PAC ID | 0446681803 |
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Medicare Enrollment ID | O20200519001824 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114547486 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Tapasya Mandalapu |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427404680 PECOS PAC ID: 2264863620 Enrollment ID: I20200519001900 |
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