| New Wave Physicians Group, Pllc | |
|
21301 Kuykendahl Rd Ste J Spring TX 77379-2614 | |
| (716) 909-6965 | |
| Not Available |
| Full Name | New Wave Physicians Group, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 21301 Kuykendahl Rd Ste J, Spring, Texas |
| Authorized Official Name and Position | Sofia S Nisha (OFFICE MANAGER) |
| Authorized Official Contact | 7134290881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Wave Physicians Group, Pllc 21301 Kuykendahl Rd Ste J Spring TX 77379-2614 Ph: (716) 909-6965 | New Wave Physicians Group, Pllc 21301 Kuykendahl Rd Ste J Spring TX 77379-2614 Ph: (716) 909-6965 |
| NPI Number | 1205424975 |
|---|---|
| Provider Enumeration Date | 01/07/2021 |
| Last Update Date | 10/20/2023 |
| Medicare PECOS PAC ID | 1254749880 |
|---|---|
| Medicare Enrollment ID | O20210421000574 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205424975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Sushma Veera Gorrela |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063482321 PECOS PAC ID: 2567363690 Enrollment ID: I20040120000737 |
| Provider Name | Amie M Sun-wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427250349 PECOS PAC ID: 3971667312 Enrollment ID: I20090210000719 |
| Provider Name | Tam M Truong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104083039 PECOS PAC ID: 8921274630 Enrollment ID: I20111230000247 |
| Provider Name | Grace Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932580743 PECOS PAC ID: 5294081378 Enrollment ID: I20180703000413 |
| Provider Name | Timothy D Carder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306290598 PECOS PAC ID: 2860788221 Enrollment ID: I20190725001712 |
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