Texas Family Practice Associates Pa | |
2540 N. Galloway Ave Suite 102 Mesquite TX 75150 | |
(972) 686-4500 | |
(972) 686-9687 |
Full Name | Texas Family Practice Associates Pa |
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Speciality | Internal Medicine |
Location | 2540 N. Galloway Ave, Mesquite, Texas |
Authorized Official Name and Position | Khurshid A. Khan (PRESIDENT) |
Authorized Official Contact | 9726864500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Texas Family Practice Associates Pa 2540 N. Galloway Ave Suite 102 Mesquite TX 75150 Ph: (972) 686-4500 | Texas Family Practice Associates Pa 2540 N. Galloway Ave Suite 102 Mesquite TX 75150 Ph: (972) 686-4500 |
NPI Number | 1215120712 |
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Provider Enumeration Date | 08/20/2007 |
Last Update Date | 02/16/2011 |
Medicare PECOS PAC ID | 9436315660 |
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Medicare Enrollment ID | O20120716000494 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215120712 | NPI | - | NPPES |
083785801 | Medicaid | TX | |
115422103 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | J4654 (Texas) | Secondary |
207R00000X | Internal Medicine | TXJ4654 (Texas) | Primary |
Provider Name | Khurshid Khan |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1467475244 PECOS PAC ID: 1951456151 Enrollment ID: I20120716000522 |
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