| Express Family Clinic | |
|
940 Ridgeview Dr Ste 150 Allen TX 75013-5544 | |
| (972) 672-4121 | |
| (972) 905-4690 |
| Full Name | Express Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 940 Ridgeview Dr Ste 150, Allen, Texas |
| Authorized Official Name and Position | Lourdes E Godfrey (OFFICE MANAGER) |
| Authorized Official Contact | 9726724121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Express Family Clinic 940 Ridgeview Dr Ste 150 Allen TX 75013-5544 Ph: (972) 672-4121 | Express Family Clinic 940 Ridgeview Dr Ste 150 Allen TX 75013-5544 Ph: (972) 672-4121 |
| NPI Number | 1144675059 |
|---|---|
| Provider Enumeration Date | 04/28/2016 |
| Last Update Date | 08/09/2023 |
| Medicare PECOS PAC ID | 0345529962 |
|---|---|
| Medicare Enrollment ID | O20161122000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144675059 | NPI | - | NPPES |
| 367021801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QS0010X | Family Medicine - Sports Medicine | M3680 (Texas) | Secondary |
| Provider Name | Pradeep S Parihar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316033418 PECOS PAC ID: 0749382182 Enrollment ID: I20070302000434 |
| Provider Name | Sunil Modi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811195365 PECOS PAC ID: 7315123684 Enrollment ID: I20130304000454 |
| Provider Name | Darshna Shahiwala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982262614 PECOS PAC ID: 3375953631 Enrollment ID: I20201028001038 |
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