| Premier Texas Kidney Care Pllc | |
|
3005 Crestwater Rdg Keller TX 76248-1424 | |
| (216) 543-2222 | |
| Not Available |
| Full Name | Premier Texas Kidney Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3005 Crestwater Rdg, Keller, Texas |
| Authorized Official Name and Position | Sridhar Allam (OWNER) |
| Authorized Official Contact | 2165432222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Texas Kidney Care Pllc 3005 Crestwater Rdg Keller TX 76248-1424 Ph: (216) 543-2222 | Premier Texas Kidney Care Pllc 3005 Crestwater Rdg Keller TX 76248-1424 Ph: (216) 543-2222 |
| NPI Number | 1275278079 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 05/05/2022 |
| Medicare PECOS PAC ID | 8527447366 |
|---|---|
| Medicare Enrollment ID | O20220624000321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275278079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Sridhar Reddy Allam |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1700061819 PECOS PAC ID: 0143498873 Enrollment ID: I20111202000115 |
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