| Pearl Family Practice Pa | |
|
950 W University Ave Building 1, Suite 104 Georgetown TX 78626-6505 | |
| (512) 869-8500 | |
| (512) 869-5052 |
| Full Name | Pearl Family Practice Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 950 W University Ave, Georgetown, Texas |
| Authorized Official Name and Position | Raju Kurunthottical (PRESIDENT/OWNER) |
| Authorized Official Contact | 5128698500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pearl Family Practice Pa 950 W University Ave Building 1, Suite 104 Georgetown TX 78626-6505 Ph: (512) 869-8500 | Pearl Family Practice Pa 950 W University Ave Building 1, Suite 104 Georgetown TX 78626-6505 Ph: (512) 869-8500 |
| NPI Number | 1992952634 |
|---|---|
| Provider Enumeration Date | 08/25/2008 |
| Last Update Date | 07/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992952634 | NPI | - | NPPES |
| 198021101 | Medicaid | TX | |
| 0009RT | Other | TX | BCBS GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K8276 (Texas) | Primary |
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