| Prime Internal Medicine Associates | |
|
12200 Park Central Dr Ste 189 Dallas TX 75251-2116 | |
| (972) 239-5445 | |
| (469) 729-6691 |
| Full Name | Prime Internal Medicine Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 12200 Park Central Dr Ste 189, Dallas, Texas |
| Authorized Official Name and Position | Shalini Katikaneni (DIRECTOR) |
| Authorized Official Contact | 9727393097 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Internal Medicine Associates 12200 Park Central Dr Ste 189 Dallas TX 75251-2116 Ph: () - | Prime Internal Medicine Associates 12200 Park Central Dr Ste 189 Dallas TX 75251-2116 Ph: (972) 239-5445 |
| NPI Number | 1538703889 |
|---|---|
| Provider Enumeration Date | 10/30/2019 |
| Last Update Date | 11/01/2021 |
| Medicare PECOS PAC ID | 5890120174 |
|---|---|
| Medicare Enrollment ID | O20200114002575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538703889 | NPI | - | NPPES |
| 197841304 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shalini Katikaneni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326221649 PECOS PAC ID: 6608938840 Enrollment ID: I20081222000345 |
| Provider Name | Della Mathew |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629028428 PECOS PAC ID: 7416914924 Enrollment ID: I20150522002015 |
Perry K. Beckstrom, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3946 S Buckner Blvd Ste 200, Dallas, TX 75227 Phone: 214-381-7194 Fax: 214-381-7195 | |
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