| Jibrail Kasperkhan, M.d. Pllc | |
|
21902 Franklin Park Apt 1308 San Antonio TX 78259-2193 | |
| (210) 479-1955 | |
| (210) 764-1561 |
| Full Name | Jibrail Kasperkhan, M.d. Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21902 Franklin Park Apt 1308, San Antonio, Texas |
| Authorized Official Name and Position | Jibrail Kasperkhan (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 2104791955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jibrail Kasperkhan, M.d. Pllc 1150 N Loop 1604 W Suite 108-641 San Antonio TX 78248-4503 Ph: (210) 479-1955 | Jibrail Kasperkhan, M.d. Pllc 21902 Franklin Park Apt 1308 San Antonio TX 78259-2193 Ph: (210) 479-1955 |
| NPI Number | 1215164843 |
|---|---|
| Provider Enumeration Date | 06/22/2009 |
| Last Update Date | 07/28/2023 |
| Medicare PECOS PAC ID | 7719168236 |
|---|---|
| Medicare Enrollment ID | O20110216000812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215164843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | M0453 (Texas) | Primary |
| Provider Name | Jibrail Kasperkhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245277300 PECOS PAC ID: 2264487107 Enrollment ID: I20050314000963 |
| Provider Name | Bianca George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326628777 PECOS PAC ID: 6901202613 Enrollment ID: I20210903002060 |
| Provider Name | Daniela Mello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720835390 PECOS PAC ID: 9335680800 Enrollment ID: I20240924003057 |
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