Multi Specialty Clinic Of Texas Pllc | |
3453 Saint Francis Ave 125 Dallas TX 75228-7199 | |
(469) 779-0884 | |
(469) 779-0920 |
Full Name | Multi Specialty Clinic Of Texas Pllc |
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Speciality | Family Medicine |
Location | 3453 Saint Francis Ave, Dallas, Texas |
Authorized Official Name and Position | Aleyamma Mathew (FNP) |
Authorized Official Contact | 4697790884 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Multi Specialty Clinic Of Texas Pllc 3453 Saint Francis Ave 125 Dallas TX 75228-7199 Ph: (469) 779-0884 | Multi Specialty Clinic Of Texas Pllc 3453 Saint Francis Ave 125 Dallas TX 75228-7199 Ph: (469) 779-0884 |
NPI Number | 1962903252 |
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Provider Enumeration Date | 02/22/2018 |
Last Update Date | 02/22/2018 |
Medicare PECOS PAC ID | 9931463379 |
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Medicare Enrollment ID | O20180510001504 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962903252 | NPI | - | NPPES |
1760911572 | Other | TX | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | AP-133700 (Texas) | Primary |
Provider Name | Aleyamma Mathew |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760911572 PECOS PAC ID: 0840554283 Enrollment ID: I20180510001536 |
Perry K. Beckstrom, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3946 S Buckner Blvd Ste 200, Dallas, TX 75227 Phone: 214-381-7194 Fax: 214-381-7195 | |
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