| Modern Medical House Calls Pllc | |
|
855 Davis Blvd Ste 500 Southlake TX 76092-8218 | |
| (817) 912-1771 | |
| (940) 241-6156 |
| Full Name | Modern Medical House Calls Pllc |
|---|---|
| Speciality | General Practice |
| Location | 855 Davis Blvd Ste 500, Southlake, Texas |
| Authorized Official Name and Position | Salim Damji (OWNER) |
| Authorized Official Contact | 8184297860 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Medical House Calls Pllc 855 Davis Blvd Ste 500 Southlake TX 76092-8218 Ph: (818) 429-7860 | Modern Medical House Calls Pllc 855 Davis Blvd Ste 500 Southlake TX 76092-8218 Ph: (817) 912-1771 |
| NPI Number | 1043635931 |
|---|---|
| Provider Enumeration Date | 02/28/2014 |
| Last Update Date | 12/19/2019 |
| Medicare PECOS PAC ID | 5092932921 |
|---|---|
| Medicare Enrollment ID | O20140815001827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043635931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jill A Gramer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447229224 PECOS PAC ID: 6103950696 Enrollment ID: I20100819000575 |
| Provider Name | Zeboonisha Damji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497034607 PECOS PAC ID: 9830361674 Enrollment ID: I20111020000310 |
| Provider Name | Lekeytra Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518395268 PECOS PAC ID: 3173846136 Enrollment ID: I20141223001010 |
| Provider Name | Darolyn D Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609272905 PECOS PAC ID: 7911210554 Enrollment ID: I20150724011704 |
| Provider Name | Rebecca M Haggen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164932778 PECOS PAC ID: 1850659871 Enrollment ID: I20171221001092 |
| Provider Name | Michelle Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598200941 PECOS PAC ID: 4486900909 Enrollment ID: I20180712003161 |
| Provider Name | Nikitha A Cherian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669014437 PECOS PAC ID: 6204261662 Enrollment ID: I20200114001296 |
| Provider Name | Khyatiben H Parikh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518565597 PECOS PAC ID: 9032529367 Enrollment ID: I20201028000069 |
| Provider Name | Alyza S Sunny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831869031 PECOS PAC ID: 5294133625 Enrollment ID: I20211014002714 |
| Provider Name | Adela P Cifuentes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649760604 PECOS PAC ID: 1456743962 Enrollment ID: I20220113000219 |
| Provider Name | Shelia Denise Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215484431 PECOS PAC ID: 5193112712 Enrollment ID: I20220429001630 |
| Provider Name | Nehalben Sachin Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720687064 PECOS PAC ID: 9739567264 Enrollment ID: I20220611000091 |
| Provider Name | Pamela D Barras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952983272 PECOS PAC ID: 3476932443 Enrollment ID: I20220622000351 |
| Provider Name | Jennifer A Conrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427474972 PECOS PAC ID: 0244539906 Enrollment ID: I20220630000455 |
| Provider Name | Soumana A Djibo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760148753 PECOS PAC ID: 1658757588 Enrollment ID: I20220930000026 |
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