Southlake Hospitalists Llc | |
1321 Bay Meadows Dr Southlake TX 76092-3938 | |
(817) 521-4747 | |
(214) 279-9273 |
Full Name | Southlake Hospitalists Llc |
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Speciality | Internal Medicine |
Location | 1321 Bay Meadows Dr, Southlake, Texas |
Authorized Official Name and Position | Elizabeth M Chandy (OWNER) |
Authorized Official Contact | 8175214747 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Southlake Hospitalists Llc Po Box 92941 Southlake TX 76092-0941 Ph: (817) 521-4747 | Southlake Hospitalists Llc 1321 Bay Meadows Dr Southlake TX 76092-3938 Ph: (817) 521-4747 |
NPI Number | 1033564729 |
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Provider Enumeration Date | 04/29/2016 |
Last Update Date | 04/29/2016 |
Medicare PECOS PAC ID | 2365731403 |
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Medicare Enrollment ID | O20160513000117 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033564729 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | M1046 (Texas) | Primary |
Provider Name | Elizabeth Chandy |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1891741179 PECOS PAC ID: 3870518582 Enrollment ID: I20051012000196 |
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