| Pramesh C Dave Md | |
|
620 Matlock Center Circle Arlington TX 76015-2536 | |
| (817) 860-1400 | |
| (214) 221-5400 |
| Full Name | Pramesh C Dave Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 620 Matlock Center Circle, Arlington, Texas |
| Authorized Official Name and Position | Pramesh C Dave (PHYSICIAN OWNER) |
| Authorized Official Contact | 8178601400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pramesh C Dave Md 620 Matlock Center Circle Arlington TX 76015-2536 Ph: (817) 860-1400 | Pramesh C Dave Md 620 Matlock Center Circle Arlington TX 76015-2536 Ph: (817) 860-1400 |
| NPI Number | 1265551402 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 11/11/2008 |
| Medicare PECOS PAC ID | 7315846169 |
|---|---|
| Medicare Enrollment ID | O20031231000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265551402 | NPI | - | NPPES |
| 081248902 | Medicaid | TX | |
| 081248901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Pramesh C Dave |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700833001 PECOS PAC ID: 4385543131 Enrollment ID: I20031231000388 |
| Provider Name | Mahendra O Thakrar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1083719231 PECOS PAC ID: 0648358101 Enrollment ID: I20080423000677 |
| Provider Name | Tairee Ruth Grimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831737899 PECOS PAC ID: 0648283101 Enrollment ID: I20200417001209 |
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