| Jeremiah Sisay, Pharmd, Md, Pllc | |
|
2698 N Galloway Ave Ste 101 Mesquite TX 75150-6384 | |
| (972) 288-1662 | |
| (972) 289-3075 |
| Full Name | Jeremiah Sisay, Pharmd, Md, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2698 N Galloway Ave Ste 101, Mesquite, Texas |
| Authorized Official Name and Position | Jeremiah Sisay (OWNER) |
| Authorized Official Contact | 9722881662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremiah Sisay, Pharmd, Md, Pllc 2698 N Galloway Ave Ste 101 Mesquite TX 75150-6384 Ph: (972) 288-1662 | Jeremiah Sisay, Pharmd, Md, Pllc 2698 N Galloway Ave Ste 101 Mesquite TX 75150-6384 Ph: (972) 288-1662 |
| NPI Number | 1497217145 |
|---|---|
| Provider Enumeration Date | 04/02/2019 |
| Last Update Date | 04/02/2019 |
| Medicare PECOS PAC ID | 1557695608 |
|---|---|
| Medicare Enrollment ID | O20190625000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497217145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ashfaq A Rasheed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750488110 PECOS PAC ID: 4385606706 Enrollment ID: I20041028000615 |
| Provider Name | Jeremiah Kassahun Sisay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194098111 PECOS PAC ID: 4385943059 Enrollment ID: I20170918003285 |
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