| Ipc Of Texas | |
|
14131 Midway Rd Suite 620 Addison TX 75001-3623 | |
| (972) 249-0200 | |
| (972) 249-0206 |
| Full Name | Ipc Of Texas |
|---|---|
| Speciality | Hospitalist |
| Location | 14131 Midway Rd, Addison, Texas |
| Authorized Official Name and Position | Lance Williams (PRESIDENT) |
| Authorized Official Contact | 8656931000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ipc Of Texas 1643 Nw 136th Ave Ste 100 Sunrise FL 33323-2857 Ph: (800) 424-3672 | Ipc Of Texas 14131 Midway Rd Suite 620 Addison TX 75001-3623 Ph: (972) 249-0200 |
| NPI Number | 1902859820 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 10/30/2020 |
| Medicare PECOS PAC ID | 7810809225 |
|---|---|
| Medicare Enrollment ID | O20031104000385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902859820 | NPI | - | NPPES |
| 126000206 | Medicaid | TX | |
| 99DQ | Other | TX | BCBS OF TX |
| 126000209 | Medicaid | TX | |
| 126000208 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | Ramesh Amara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104892959 PECOS PAC ID: 9234200619 Enrollment ID: I20080612000014 |
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