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4920 Mcdermott Rd Ste 200 Plano TX 75024-7769 | |
| (972) 200-5666 | |
| (469) 250-5460 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 4920 Mcdermott Rd Ste 200, Plano, Texas |
| Authorized Official Name and Position | Priti Ranjan (OWNER) |
| Authorized Official Contact | 4348515633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4920 Mcdermott Rd Ste 200 Plano TX 75024-7769 Ph: (972) 200-5666 | 4920 Mcdermott Rd Ste 200 Plano TX 75024-7769 Ph: (972) 200-5666 |
| NPI Number | 1275018608 |
|---|---|
| Provider Enumeration Date | 10/02/2018 |
| Last Update Date | 01/25/2019 |
| Medicare PECOS PAC ID | 5092068130 |
|---|---|
| Medicare Enrollment ID | O20181019000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275018608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Priti Ranjan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356579247 PECOS PAC ID: 7517190218 Enrollment ID: I20140505000783 |
| Provider Name | Kavita A Chitale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487111688 PECOS PAC ID: 6103154208 Enrollment ID: I20200218000572 |
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