| Mesquite Regional Internal Medicine | |
|
929 N Galloway Ave Ste 104 Mesquite TX 75149-2400 | |
| (972) 216-0079 | |
| Not Available |
| Full Name | Mesquite Regional Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 929 N Galloway Ave Ste 104, Mesquite, Texas |
| Authorized Official Name and Position | Anuradha L Mundluru (OWNER) |
| Authorized Official Contact | 9722160079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mesquite Regional Internal Medicine 929 N Galloway Ave Ste 104 Mesquite TX 75149-2400 Ph: (972) 216-0079 | Mesquite Regional Internal Medicine 929 N Galloway Ave Ste 104 Mesquite TX 75149-2400 Ph: (972) 216-0079 |
| NPI Number | 1144516212 |
|---|---|
| Provider Enumeration Date | 06/27/2011 |
| Last Update Date | 04/30/2012 |
| Medicare PECOS PAC ID | 6709048176 |
|---|---|
| Medicare Enrollment ID | O20120501000267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144516212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Anuradha L Mundluru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225038862 PECOS PAC ID: 5597845495 Enrollment ID: I20080104000357 |
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