| Pcp Associates Of Pasadena Pa | |
|
4102 Woodlawn Ave Suite 150 Pasadena TX 77504 | |
| (713) 943-8229 | |
| (713) 943-9608 |
| Full Name | Pcp Associates Of Pasadena Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4102 Woodlawn Ave, Pasadena, Texas |
| Authorized Official Name and Position | Deepak Pattanaik (PRESIDENT) |
| Authorized Official Contact | 7139438229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pcp Associates Of Pasadena Pa 4102 Woodlawn Ave Suite 150 Pasadena TX 77504 Ph: (713) 943-8229 | Pcp Associates Of Pasadena Pa 4102 Woodlawn Ave Suite 150 Pasadena TX 77504 Ph: (713) 943-8229 |
| NPI Number | 1467673301 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8527056522 |
|---|---|
| Medicare Enrollment ID | O20040505001808 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467673301 | NPI | - | NPPES |
| 0096CV | Other | BCBS OF TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Abraham S John |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184707887 PECOS PAC ID: 6002804044 Enrollment ID: I20040506000226 |
| Provider Name | Deepak Pattanaik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033292743 PECOS PAC ID: 4880682889 Enrollment ID: I20100802000133 |
| Provider Name | Kent D Schnell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083797799 PECOS PAC ID: 7113113127 Enrollment ID: I20101201001243 |
| Provider Name | Aisha Amin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689957482 PECOS PAC ID: 8022261668 Enrollment ID: I20170612002062 |
| Provider Name | Kelly B Padgett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689133456 PECOS PAC ID: 5799027066 Enrollment ID: I20190507002053 |
| Provider Name | Kyle Kettle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861092504 PECOS PAC ID: 8123431400 Enrollment ID: I20210105002089 |
| Provider Name | Natalia Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740810928 PECOS PAC ID: 9335535418 Enrollment ID: I20220330001365 |
| Provider Name | Anna Ventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831896802 PECOS PAC ID: 3274905294 Enrollment ID: I20230220002193 |
| Provider Name | Melissa V Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043904642 PECOS PAC ID: 2860856507 Enrollment ID: I20230913001767 |
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