Metro Geriatric Services Pa | |
2804 Fox Creek Trl Arlington TX 76017-7960 | |
(817) 659-5395 | |
(817) 439-6767 |
Full Name | Metro Geriatric Services Pa |
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Speciality | Family Medicine |
Location | 2804 Fox Creek Trl, Arlington, Texas |
Authorized Official Name and Position | Vijaya Sudanagunta (PRESIDENT) |
Authorized Official Contact | 8176595393 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Metro Geriatric Services Pa 2804 Fox Creek Trl Arlington TX 76017-7960 Ph: (817) 659-5395 | Metro Geriatric Services Pa 2804 Fox Creek Trl Arlington TX 76017-7960 Ph: (817) 659-5395 |
NPI Number | 1174870026 |
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Provider Enumeration Date | 08/09/2012 |
Last Update Date | 08/09/2012 |
Medicare PECOS PAC ID | 5991954463 |
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Medicare Enrollment ID | O20120927000777 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174870026 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Vijaya Sudanagunta |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1265442602 PECOS PAC ID: 3678531860 Enrollment ID: I20080820000475 |
Provider Name | Myoungsook Jeong |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770834947 PECOS PAC ID: 8123271483 Enrollment ID: I20130117000183 |
Provider Name | Lindsey Diaz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730559097 PECOS PAC ID: 1153631486 Enrollment ID: I20151117000571 |
Provider Name | Sheletha Bratton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649642497 PECOS PAC ID: 0941503908 Enrollment ID: I20160125002668 |
Provider Name | Candace L Adkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609330810 PECOS PAC ID: 6204175557 Enrollment ID: I20190304001322 |
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