| Step Up Sports Medicine Pllc | |
|
3020 Corporate Ct Ste 400 Flower Mound TX 75028-5617 | |
| (817) 668-3222 | |
| (817) 668-3200 |
| Full Name | Step Up Sports Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3020 Corporate Ct Ste 400, Flower Mound, Texas |
| Authorized Official Name and Position | Naga Sai Venkata H Madhavapeddi (OWNER) |
| Authorized Official Contact | 8176683222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Step Up Sports Medicine Pllc 3020 Corporate Ct Ste 400 Flower Mound TX 75028-5617 Ph: (817) 668-3222 | Step Up Sports Medicine Pllc 3020 Corporate Ct Ste 400 Flower Mound TX 75028-5617 Ph: (817) 668-3222 |
| NPI Number | 1891475026 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 07/24/2023 |
| Medicare PECOS PAC ID | 8527422401 |
|---|---|
| Medicare Enrollment ID | O20230911002815 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891475026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Naga Sai Venkata Hanumantha Rao Madhavapeddi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467815043 PECOS PAC ID: 0446508121 Enrollment ID: I20191223001188 |
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