| Tx Primary Care Plus | |
|
5040 Tennyson Pkwy Plano TX 75024-3002 | |
| (469) 476-7810 | |
| (469) 574-7840 |
| Full Name | Tx Primary Care Plus |
|---|---|
| Speciality | Internal Medicine |
| Location | 5040 Tennyson Pkwy, Plano, Texas |
| Authorized Official Name and Position | Venkatesh Madhav (MANAGER) |
| Authorized Official Contact | 4694767810 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tx Primary Care Plus 5040 Tennyson Pkwy Plano TX 75024-3002 Ph: (469) 476-7810 | Tx Primary Care Plus 5040 Tennyson Pkwy Plano TX 75024-3002 Ph: (469) 476-7810 |
| NPI Number | 1952875064 |
|---|---|
| Provider Enumeration Date | 01/11/2019 |
| Last Update Date | 07/22/2021 |
| Medicare PECOS PAC ID | 9830439769 |
|---|---|
| Medicare Enrollment ID | O20190312003346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952875064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Venkatesh V Madhav |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144274341 PECOS PAC ID: 4981687050 Enrollment ID: I20040609001521 |
| Provider Name | Ravikumar Hanumanthaiah Edalur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023221413 PECOS PAC ID: 5193809465 Enrollment ID: I20080225000770 |
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