| Southern Endocrinology Associates | |
|
3500 Ih-30 Buidling D Suite 203 Mesquite TX 75150 | |
| (972) 682-5700 | |
| Not Available |
| Full Name | Southern Endocrinology Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 3500 Ih-30 Buidling D, Mesquite, Texas |
| Authorized Official Name and Position | Sumana Gangi (DIRECTOR) |
| Authorized Official Contact | 2149098904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Endocrinology Associates 3500 I-30 At Motley Building D, Suite # 203 Mesquite TX 75150 Ph: (972) 682-5700 | Southern Endocrinology Associates 3500 Ih-30 Buidling D Suite 203 Mesquite TX 75150 Ph: (972) 682-5700 |
| NPI Number | 1811096480 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9638271711 |
|---|---|
| Medicare Enrollment ID | O20070423000250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811096480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | M4788 (Texas) | Primary |
| 261Q00000X | Clinic/center | MA07612100 (New Jersey) | Primary |
| Provider Name | Qing Jia |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1609805506 PECOS PAC ID: 6305821588 Enrollment ID: I20040622000595 |
| Provider Name | Sumana Gangi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1487679213 PECOS PAC ID: 4284736356 Enrollment ID: I20070220000272 |
| Provider Name | Rosemarie Lajara |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1780862102 PECOS PAC ID: 0941361190 Enrollment ID: I20081205000367 |
| Provider Name | Sreedevi Guttikonda |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407050073 PECOS PAC ID: 2264604230 Enrollment ID: I20111017000707 |
| Provider Name | Anthony Ted Chuang |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1891082327 PECOS PAC ID: 5092936351 Enrollment ID: I20141030000453 |
| Provider Name | Shalini Paturi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215191754 PECOS PAC ID: 5698940955 Enrollment ID: I20180110003153 |
| Provider Name | Nilam H Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528670437 PECOS PAC ID: 5991125247 Enrollment ID: I20201026002760 |
| Provider Name | Laura K Long |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1306439419 PECOS PAC ID: 1355748898 Enrollment ID: I20210924002613 |
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