| Radha Tamerisa Md Pa | |
|
1331 W Grand Pkwy N Suite 350 Katy TX 77493-2710 | |
| (281) 395-8688 | |
| (281) 395-8480 |
| Full Name | Radha Tamerisa Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1331 W Grand Pkwy N, Katy, Texas |
| Authorized Official Name and Position | Radha A Tamerisa (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2813958688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radha Tamerisa Md Pa 1331 W Grand Pkwy N Suite 350 Katy TX 77493-2710 Ph: (281) 395-8688 | Radha Tamerisa Md Pa 1331 W Grand Pkwy N Suite 350 Katy TX 77493-2710 Ph: (281) 395-8688 |
| NPI Number | 1730610320 |
|---|---|
| Provider Enumeration Date | 03/24/2017 |
| Last Update Date | 03/24/2017 |
| Medicare PECOS PAC ID | 4789952060 |
|---|---|
| Medicare Enrollment ID | O20170608002052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730610320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | L7210 (Texas) | Primary |
| Provider Name | Radha A Tamerisa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366440653 PECOS PAC ID: 0244234201 Enrollment ID: I20060905000394 |
| Provider Name | Jordan Shapiro |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073839239 PECOS PAC ID: 3577795335 Enrollment ID: I20200326000488 |
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