Vijaya Nama M.d Pa | |
5115 N Galloway Ave Ste 304 Mesquite TX 75150-7535 | |
(972) 613-2127 | |
(972) 613-2726 |
Full Name | Vijaya Nama M.d Pa |
---|---|
Speciality | Family Medicine |
Location | 5115 N Galloway Ave Ste 304, Mesquite, Texas |
Authorized Official Name and Position | Vijaya Nama (DIRECTOR) |
Authorized Official Contact | 9726132127 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Vijaya Nama M.d Pa Po Box 851484 Mesquite TX 75185-1484 Ph: (972) 613-2127 | Vijaya Nama M.d Pa 5115 N Galloway Ave Ste 304 Mesquite TX 75150-7535 Ph: (972) 613-2127 |
NPI Number | 1770770638 |
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Provider Enumeration Date | 09/25/2007 |
Last Update Date | 01/27/2012 |
Medicare PECOS PAC ID | 0244236818 |
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Medicare Enrollment ID | O20061005000115 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770770638 | NPI | - | NPPES |
187640101 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | L7821 (Texas) | Primary |
Provider Name | Vijaya Nama |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306829791 PECOS PAC ID: 4284617234 Enrollment ID: I20040722000593 |
Provider Name | Timonet B Abuloc |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548427156 PECOS PAC ID: 4789755190 Enrollment ID: I20080612000311 |
Provider Name | Siby Thomas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497140867 PECOS PAC ID: 7012340466 Enrollment ID: I20191126000609 |
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