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12828 Eldorado Parkway Frisco TX 75035 | |
| (866) 600-9547 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 12828 Eldorado Parkway, Frisco, Texas |
| Authorized Official Name and Position | Varalakshmi Jhingade Devesh (DIRECTOR) |
| Authorized Official Contact | 8666009547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8209 Sutherland Ln Plano TX 75025-5547 Ph: (214) 785-9971 | 12828 Eldorado Parkway Frisco TX 75035 Ph: (866) 600-9547 |
| NPI Number | 1376004655 |
|---|---|
| Provider Enumeration Date | 03/28/2019 |
| Last Update Date | 09/04/2019 |
| Medicare PECOS PAC ID | 0143553594 |
|---|---|
| Medicare Enrollment ID | O20190618000395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376004655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Sharad S Swami |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548217813 PECOS PAC ID: 1052317757 Enrollment ID: I20111130000062 |
| Provider Name | Varalakshmi J Devesh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104070515 PECOS PAC ID: 8426247826 Enrollment ID: I20151002000490 |
| Provider Name | Rajnil G Shah |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619284189 PECOS PAC ID: 4688897515 Enrollment ID: I20161212000489 |
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