| Total Care Family Practice, Llc | |
|
1200 E Davis St Ste 113 Mesquite TX 75149-8711 | |
| (972) 295-9090 | |
| (972) 534-0010 |
| Full Name | Total Care Family Practice, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1200 E Davis St Ste 113, Mesquite, Texas |
| Authorized Official Name and Position | Larry Stubblefield (LAB DIRECTOR) |
| Authorized Official Contact | 9722959090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Care Family Practice, Llc 1200 E Davis St Ste 113 Mesquite TX 75149-8711 Ph: (972) 295-9090 | Total Care Family Practice, Llc 1200 E Davis St Ste 113 Mesquite TX 75149-8711 Ph: (972) 295-9090 |
| NPI Number | 1538442603 |
|---|---|
| Provider Enumeration Date | 09/24/2011 |
| Last Update Date | 02/23/2022 |
| Medicare PECOS PAC ID | 3678735586 |
|---|---|
| Medicare Enrollment ID | O20120509000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538442603 | NPI | - | NPPES |
| 061252511 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Vishnu M Upadhyay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386700151 PECOS PAC ID: 8921168931 Enrollment ID: I20081120000722 |
| Provider Name | Mario G Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669591871 PECOS PAC ID: 5496840530 Enrollment ID: I20140303000508 |
| Provider Name | Sheena Prejith Nair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730652538 PECOS PAC ID: 1658722699 Enrollment ID: I20240104000172 |
| Provider Name | Shaista Manzoor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184321747 PECOS PAC ID: 6406207935 Enrollment ID: I20240109004711 |
| Provider Name | Brittany Dawn Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881374635 PECOS PAC ID: 5799136073 Enrollment ID: I20240111000903 |
| Provider Name | Shoro Kundu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609538743 PECOS PAC ID: 2365893666 Enrollment ID: I20240111001616 |
| Provider Name | Dominique Cormier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033990692 PECOS PAC ID: 8921479650 Enrollment ID: I20240202000474 |
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