| Heritage Parkway Medical Pllc | |
|
3415 North Heritage Parkway Sherman TX 75092 | |
| (903) 308-4336 | |
| Not Available |
| Full Name | Heritage Parkway Medical Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3415 North Heritage Parkway, Sherman, Texas |
| Authorized Official Name and Position | Nidish Jose (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4698447072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Parkway Medical Pllc 3415 North Heritage Parkway Sherman TX 75092 Ph: (903) 308-4336 | Heritage Parkway Medical Pllc 3415 North Heritage Parkway Sherman TX 75092 Ph: (903) 308-4336 |
| NPI Number | 1770140550 |
|---|---|
| Provider Enumeration Date | 05/28/2019 |
| Last Update Date | 03/19/2024 |
| Medicare PECOS PAC ID | 0547595852 |
|---|---|
| Medicare Enrollment ID | O20190709002032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770140550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Diane R Keahey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912013988 PECOS PAC ID: 2466411574 Enrollment ID: I20041005000822 |
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