| Khem Labs Llc | |
|
2411 Williams Dr Ste 3 Georgetown TX 78628-3261 | |
| (512) 661-8521 | |
| (512) 820-1244 |
| Full Name | Khem Labs Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2411 Williams Dr Ste 3, Georgetown, Texas |
| Authorized Official Name and Position | Kunal Nagarsheth (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8326877167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Khem Labs Llc 6701 Zenith Cv Austin TX 78759-4695 Ph: (512) 661-8521 | Khem Labs Llc 2411 Williams Dr Ste 3 Georgetown TX 78628-3261 Ph: (512) 661-8521 |
| NPI Number | 1194485870 |
|---|---|
| Provider Enumeration Date | 12/22/2021 |
| Last Update Date | 07/15/2022 |
| Medicare PECOS PAC ID | 1052702800 |
|---|---|
| Medicare Enrollment ID | O20220105001127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194485870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Paula C Bordelon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821156340 PECOS PAC ID: 4688778202 Enrollment ID: I20150413001219 |
| Provider Name | Richard E Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134563927 PECOS PAC ID: 5294029591 Enrollment ID: I20160809003095 |
| Provider Name | Joel Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194783472 PECOS PAC ID: 7517943327 Enrollment ID: I20210913001306 |
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