| S Iyer Pa | |
|
802 North Bonnie Brae Street Suite 104 Denton TX 76201-2301 | |
| (940) 565-0373 | |
| (940) 565-0413 |
| Full Name | S Iyer Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 802 North Bonnie Brae Street, Denton, Texas |
| Authorized Official Name and Position | Sridhar K Iyer (MD/OWNER) |
| Authorized Official Contact | 9405650373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S Iyer Pa Po Box 50658 Denton TX 76206-0658 Ph: (940) 565-0373 | S Iyer Pa 802 North Bonnie Brae Street Suite 104 Denton TX 76201-2301 Ph: (940) 565-0373 |
| NPI Number | 1700117355 |
|---|---|
| Provider Enumeration Date | 01/21/2010 |
| Last Update Date | 03/28/2016 |
| Medicare PECOS PAC ID | 9436289345 |
|---|---|
| Medicare Enrollment ID | O20100618000475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700117355 | NPI | - | NPPES |
| 213642601 | Medicaid | TX |
| Provider Name | Sridhar K Iyer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1043299712 PECOS PAC ID: 3375674203 Enrollment ID: I20100622000613 |
| Provider Name | Robin L Moreno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366844987 PECOS PAC ID: 6800119702 Enrollment ID: I20141230000496 |
| Provider Name | Tosin O Oshionebo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538529797 PECOS PAC ID: 8729363460 Enrollment ID: I20170321001698 |
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