| Pelican Medical Specialists Pllc | |
|
5012 Us Hwy 75 Ste 205 Denison TX 75020-4635 | |
| (972) 674-9910 | |
| (972) 666-5959 |
| Full Name | Pelican Medical Specialists Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5012 Us Hwy 75 Ste 205, Denison, Texas |
| Authorized Official Name and Position | Mohammed Moizuddin (DIRECTOR) |
| Authorized Official Contact | 9726479910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pelican Medical Specialists Pllc 1022 Kenilworth St Allen TX 75013-5828 Ph: (972) 674-9910 | Pelican Medical Specialists Pllc 5012 Us Hwy 75 Ste 205 Denison TX 75020-4635 Ph: (972) 674-9910 |
| NPI Number | 1902380009 |
|---|---|
| Provider Enumeration Date | 09/24/2018 |
| Last Update Date | 10/29/2022 |
| Medicare PECOS PAC ID | 7618206939 |
|---|---|
| Medicare Enrollment ID | O20190912000680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902380009 | NPI | - | NPPES |
| 405864601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Mohammed Moizuddin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083722292 PECOS PAC ID: 7719919885 Enrollment ID: I20181108000323 |
| Provider Name | Quretul Quresh |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1396056966 PECOS PAC ID: 0143457077 Enrollment ID: I20191002002859 |
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