| Vipcare Texas Llc | |
|
3602 Matlock Rd Ste 206 Arlington TX 76015-3600 | |
| (682) 282-4460 | |
| (682) 282-4462 |
| Full Name | Vipcare Texas Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3602 Matlock Rd Ste 206, Arlington, Texas |
| Authorized Official Name and Position | Sriram Sundaramoorthy (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 3526227000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vipcare Texas Llc 601 S Harbour Island Blvd Ste 200 Tampa FL 33602-5925 Ph: (813) 444-5838 | Vipcare Texas Llc 3602 Matlock Rd Ste 206 Arlington TX 76015-3600 Ph: (682) 282-4460 |
| NPI Number | 1356069777 |
|---|---|
| Provider Enumeration Date | 08/22/2022 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 6002283843 |
|---|---|
| Medicare Enrollment ID | O20221108000036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356069777 | NPI | - | NPPES |
| Provider Name | Micheal Allan Moisant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063463800 PECOS PAC ID: 1355330499 Enrollment ID: I20040512000467 |
| Provider Name | Lisa L Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922087139 PECOS PAC ID: 3476515933 Enrollment ID: I20041028000132 |
| Provider Name | Howard E Kweller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952385494 PECOS PAC ID: 6002987245 Enrollment ID: I20100312000382 |
| Provider Name | Dee G Mccrary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942203278 PECOS PAC ID: 9931090263 Enrollment ID: I20100427000797 |
| Provider Name | Cynthia Gneco Wilamo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053699884 PECOS PAC ID: 9537386172 Enrollment ID: I20170731003457 |
| Provider Name | Chasity Lynn Stovall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073016556 PECOS PAC ID: 7911253794 Enrollment ID: I20180710000139 |
| Provider Name | Jose Quiles Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033489679 PECOS PAC ID: 8426489329 Enrollment ID: I20230629003128 |
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