| Texas Geriatrics | |
|
1580 S Main St Ste 101 Boerne TX 78006-3312 | |
| (830) 443-9958 | |
| Not Available |
| Full Name | Texas Geriatrics |
|---|---|
| Speciality | Family Medicine |
| Location | 1580 S Main St Ste 101, Boerne, Texas |
| Authorized Official Name and Position | Ranjitha Gampala (PHYSICIAN) |
| Authorized Official Contact | 2106938164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Geriatrics 18823 Rogers Pass San Antonio TX 78258-4621 Ph: (210) 493-7995 | Texas Geriatrics 1580 S Main St Ste 101 Boerne TX 78006-3312 Ph: (830) 443-9958 |
| NPI Number | 1639563240 |
|---|---|
| Provider Enumeration Date | 03/20/2015 |
| Last Update Date | 03/27/2015 |
| Medicare PECOS PAC ID | 9234456419 |
|---|---|
| Medicare Enrollment ID | O20150327000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639563240 | NPI | - | NPPES |
| 211019901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| Provider Name | Ranjitha Gampala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346423688 PECOS PAC ID: 7214077866 Enrollment ID: I20091214000022 |
| Provider Name | Jyoti Kc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972048361 PECOS PAC ID: 3971880782 Enrollment ID: I20170504000942 |
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