| Northside Doctors, P.a. | |
|
920 Medical Plaza Drive Suite 360 Shenandoah TX 77380-3271 | |
| (281) 719-0483 | |
| (281) 719-0756 |
| Full Name | Northside Doctors, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 920 Medical Plaza Drive, Shenandoah, Texas |
| Authorized Official Name and Position | Duyen My Tran (PRESIDENT) |
| Authorized Official Contact | 2817190483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Doctors, P.a. 920 Medical Plaza Drive Suite 360 Shenandoah TX 77380-3271 Ph: (281) 719-0483 | Northside Doctors, P.a. 920 Medical Plaza Drive Suite 360 Shenandoah TX 77380-3271 Ph: (281) 719-0483 |
| NPI Number | 1487729323 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 01/14/2013 |
| Medicare PECOS PAC ID | 4880696558 |
|---|---|
| Medicare Enrollment ID | O20070208000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487729323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L7582 (Texas) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | L7582 (Texas) | Primary |
| Provider Name | Duyen My Tran |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1508853037 PECOS PAC ID: 4284695685 Enrollment ID: I20041019001394 |
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