| Sr Medical Clinic Pllc | |
|
5990 Airline Dr 250 Houston TX 77076-4237 | |
| (713) 695-8180 | |
| Not Available |
| Full Name | Sr Medical Clinic Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5990 Airline Dr, Houston, Texas |
| Authorized Official Name and Position | Sadasivareddy Goli (PHYSICIAN) |
| Authorized Official Contact | 7136958180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sr Medical Clinic Pllc Po Box 38252 Houston TX 77238-8252 Ph: () - | Sr Medical Clinic Pllc 5990 Airline Dr 250 Houston TX 77076-4237 Ph: (713) 695-8180 |
| NPI Number | 1467883694 |
|---|---|
| Provider Enumeration Date | 12/13/2013 |
| Last Update Date | 03/25/2014 |
| Medicare PECOS PAC ID | 1557584851 |
|---|---|
| Medicare Enrollment ID | O20140513001855 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467883694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L3314 (Texas) | Primary |
| Provider Name | Sadasivareddy Goli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831100676 PECOS PAC ID: 2062593304 Enrollment ID: I20080114000084 |
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