| Shridhar Kotta Md Pa | |
|
512 Victoria Ln Ste 4 Harlingen TX 78550-3227 | |
| (956) 341-6440 | |
| Not Available |
| Full Name | Shridhar Kotta Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 512 Victoria Ln Ste 4, Harlingen, Texas |
| Authorized Official Name and Position | Shridhar Kotta (OWNER) |
| Authorized Official Contact | 9563416440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shridhar Kotta Md Pa Po Box 532409 Harlingen TX 78553-2409 Ph: (956) 341-6440 | Shridhar Kotta Md Pa 512 Victoria Ln Ste 4 Harlingen TX 78550-3227 Ph: (956) 341-6440 |
| NPI Number | 1265663165 |
|---|---|
| Provider Enumeration Date | 07/27/2009 |
| Last Update Date | 12/14/2009 |
| Medicare PECOS PAC ID | 2466506522 |
|---|---|
| Medicare Enrollment ID | O20090825000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265663165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shridhar Kotta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780674432 PECOS PAC ID: 1759465768 Enrollment ID: I20090825000095 |
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