| Modera Gi | |
|
5575 Frisco Square Blvd 220 Frisco TX 75034-3303 | |
| (469) 920-2302 | |
| Not Available |
| Full Name | Modera Gi |
|---|---|
| Speciality | Internal Medicine |
| Location | 5575 Frisco Square Blvd, Frisco, Texas |
| Authorized Official Name and Position | Trevor Huber (PRESIDENT) |
| Authorized Official Contact | 9729870458 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modera Gi 5575 Frisco Square Blvd #220 Frisco TX 75034-3303 Ph: (469) 920-2302 | Modera Gi 5575 Frisco Square Blvd 220 Frisco TX 75034-3303 Ph: (469) 920-2302 |
| NPI Number | 1063142115 |
|---|---|
| Provider Enumeration Date | 06/13/2022 |
| Last Update Date | 10/04/2023 |
| Medicare PECOS PAC ID | 7517334741 |
|---|---|
| Medicare Enrollment ID | O20221101002038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063142115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Amir Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205824810 PECOS PAC ID: 0244210151 Enrollment ID: I20040730000829 |
| Provider Name | David P Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992064976 PECOS PAC ID: 9032419296 Enrollment ID: I20151120000391 |
| Provider Name | Trevor K Huber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649682857 PECOS PAC ID: 2264723618 Enrollment ID: I20160615002044 |
| Provider Name | Neema M Saraiya |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851736078 PECOS PAC ID: 6800197757 Enrollment ID: I20191024002694 |
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