| Medtruly Medical Group Pllc | |
|
4400 N Midland Dr Ste 2870f Midland TX 79707-3385 | |
| (888) 801-2012 | |
| (408) 762-5948 |
| Full Name | Medtruly Medical Group Pllc |
|---|---|
| Speciality | General Practice |
| Location | 4400 N Midland Dr Ste 2870f, Midland, Texas |
| Authorized Official Name and Position | Sajad Zalzala (OWNER) |
| Authorized Official Contact | 8888012012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medtruly Medical Group Pllc 920 N 1st St Renton WA 98057-5759 Ph: (888) 801-2012 | Medtruly Medical Group Pllc 4400 N Midland Dr Ste 2870f Midland TX 79707-3385 Ph: (888) 801-2012 |
| NPI Number | 1437739745 |
|---|---|
| Provider Enumeration Date | 04/11/2021 |
| Last Update Date | 03/02/2022 |
| Medicare PECOS PAC ID | 5991113359 |
|---|---|
| Medicare Enrollment ID | O20210423000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437739745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | John Borrego |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780745539 PECOS PAC ID: 5294800389 Enrollment ID: I20080825000579 |
| Provider Name | Irene A Carrothers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003041831 PECOS PAC ID: 0547418238 Enrollment ID: I20120921000667 |
| Provider Name | Edesiri P Akajagbor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013301043 PECOS PAC ID: 2365783354 Enrollment ID: I20190329002261 |
| Provider Name | Breta A Lieke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497203632 PECOS PAC ID: 3173806254 Enrollment ID: I20201104001266 |
| Provider Name | Jennifer Foxell Bluntzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114536166 PECOS PAC ID: 8426469842 Enrollment ID: I20201116001498 |
| Provider Name | Maria Christina Cruz Tijerina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366055675 PECOS PAC ID: 4486052768 Enrollment ID: I20211018002644 |
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