| Medicure Family Clinic | |
|
1038 N Carrier Pkwy Grand Prairie TX 75050-3301 | |
| (321) 543-0205 | |
| Not Available |
| Full Name | Medicure Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1038 N Carrier Pkwy, Grand Prairie, Texas |
| Authorized Official Name and Position | Smitha Issac (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2145186404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicure Family Clinic 1038 N Carrier Pkwy Grand Prairie TX 75050-3301 Ph: () - | Medicure Family Clinic 1038 N Carrier Pkwy Grand Prairie TX 75050-3301 Ph: (321) 543-0205 |
| NPI Number | 1154963163 |
|---|---|
| Provider Enumeration Date | 10/10/2019 |
| Last Update Date | 12/30/2022 |
| Medicare PECOS PAC ID | 5395177372 |
|---|---|
| Medicare Enrollment ID | O20191113000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154963163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Beena Bency John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881196327 PECOS PAC ID: 9436495850 Enrollment ID: I20190107000886 |
| Provider Name | Smitha Issac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558852533 PECOS PAC ID: 1557608619 Enrollment ID: I20190128001165 |
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