| Tyler Family Medical Plaza Md Pa | |
|
922 E Tyler Ave Harlingen TX 78550-7134 | |
| (956) 400-7000 | |
| (956) 400-7042 |
| Full Name | Tyler Family Medical Plaza Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 922 E Tyler Ave, Harlingen, Texas |
| Authorized Official Name and Position | Prasad V Movva (DR.) |
| Authorized Official Contact | 9564407000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler Family Medical Plaza Md Pa 922 E Tyler Ave Harlingen TX 78550-7134 Ph: (956) 400-7000 | Tyler Family Medical Plaza Md Pa 922 E Tyler Ave Harlingen TX 78550-7134 Ph: (956) 400-7000 |
| NPI Number | 1306966403 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 06/09/2010 |
| Medicare PECOS PAC ID | 3173586039 |
|---|---|
| Medicare Enrollment ID | O20041111000041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306966403 | NPI | - | NPPES |
| 143023038 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K6169 (Texas) | Primary |
| Provider Name | Prasad V Movva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053319897 PECOS PAC ID: 2961303821 Enrollment ID: I20040115000240 |
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