Meridian Primary Care Pllc | |
5430 Abington Creek Ln Sugar Land TX 77479-4382 | |
(510) 463-7717 | |
Not Available |
Full Name | Meridian Primary Care Pllc |
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Speciality | Family Medicine |
Location | 5430 Abington Creek Ln, Sugar Land, Texas |
Authorized Official Name and Position | Subha Rajitha Dommaraju (OWNER) |
Authorized Official Contact | 5104637717 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Meridian Primary Care Pllc Po Box 16008 Sugar Land TX 77496-6008 Ph: () - | Meridian Primary Care Pllc 5430 Abington Creek Ln Sugar Land TX 77479-4382 Ph: (510) 463-7717 |
NPI Number | 1184289613 |
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Provider Enumeration Date | 05/09/2019 |
Last Update Date | 07/13/2020 |
Medicare PECOS PAC ID | 8224363478 |
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Medicare Enrollment ID | O20190711000187 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184289613 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Subha Rajitha Dommaraju |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1154577393 PECOS PAC ID: 3173769189 Enrollment ID: I20130418000038 |
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