| Waterloo Park Inpatient Services Pllc | |
|
5016 S Us Highway 75 Denison TX 75020-4584 | |
| (973) 251-1132 | |
| Not Available |
| Full Name | Waterloo Park Inpatient Services Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5016 S Us Highway 75, Denison, Texas |
| Authorized Official Name and Position | Kathy Kondas (OFFICER) |
| Authorized Official Contact | 9732511132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterloo Park Inpatient Services Pllc 13737 Noel Rd Suite 1600 Dallas TX 75240-1331 Ph: () - | Waterloo Park Inpatient Services Pllc 5016 S Us Highway 75 Denison TX 75020-4584 Ph: (973) 251-1132 |
| NPI Number | 1013343912 |
|---|---|
| Provider Enumeration Date | 09/24/2013 |
| Last Update Date | 12/05/2019 |
| Medicare PECOS PAC ID | 4880820513 |
|---|---|
| Medicare Enrollment ID | O20131202000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013343912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Srinivasa R Mandadapu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326060435 PECOS PAC ID: 7810982667 Enrollment ID: I20040420000179 |
| Provider Name | Srilatha Vellanki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952346579 PECOS PAC ID: 0042299414 Enrollment ID: I20040719000721 |
| Provider Name | Robert L Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184686073 PECOS PAC ID: 7012965536 Enrollment ID: I20050111000445 |
| Provider Name | Anilkumar R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538188941 PECOS PAC ID: 5496786410 Enrollment ID: I20050907000823 |
| Provider Name | Sudhamayi Molakalapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245265891 PECOS PAC ID: 8123045010 Enrollment ID: I20051031000212 |
| Provider Name | Meena Betha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699752063 PECOS PAC ID: 8224056817 Enrollment ID: I20051102000575 |
| Provider Name | Birendra Lal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760437719 PECOS PAC ID: 2567480395 Enrollment ID: I20051109001069 |
| Provider Name | Manohar Yedulapuram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407858426 PECOS PAC ID: 6608842497 Enrollment ID: I20060509000205 |
| Provider Name | Douglas P Myers |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1457302127 PECOS PAC ID: 0547249286 Enrollment ID: I20070124000292 |
| Provider Name | Qaiser Saeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194883207 PECOS PAC ID: 3779683792 Enrollment ID: I20070705000234 |
| Provider Name | Arshia J Quadri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255528790 PECOS PAC ID: 7517047210 Enrollment ID: I20080108000341 |
| Provider Name | Rafiquddin S Rahimi |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1386713329 PECOS PAC ID: 3476573122 Enrollment ID: I20100608000109 |
| Provider Name | Robert P Fischer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407867591 PECOS PAC ID: 3779562699 Enrollment ID: I20101112001132 |
| Provider Name | Sarah E Boucher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982805339 PECOS PAC ID: 7911171160 Enrollment ID: I20111128000171 |
| Provider Name | Fawad A Tufail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558371682 PECOS PAC ID: 8729067806 Enrollment ID: I20111215000407 |
| Provider Name | Tanvir Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649280777 PECOS PAC ID: 3274522990 Enrollment ID: I20111220000555 |
| Provider Name | Mateen A Dawood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831107101 PECOS PAC ID: 9739132168 Enrollment ID: I20111221000507 |
| Provider Name | Azar Ehsan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851616304 PECOS PAC ID: 0143480517 Enrollment ID: I20120321000587 |
| Provider Name | Farah Masood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447403563 PECOS PAC ID: 1850551037 Enrollment ID: I20120326000515 |
| Provider Name | Maqsood A Bhatti |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1629084454 PECOS PAC ID: 1254337116 Enrollment ID: I20120807000856 |
| Provider Name | Tayyab H Malik |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1073535092 PECOS PAC ID: 8426054511 Enrollment ID: I20120816000605 |
| Provider Name | Praneetha Puskuri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851581656 PECOS PAC ID: 4082894373 Enrollment ID: I20121004000606 |
| Provider Name | Umesh Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285864777 PECOS PAC ID: 7810140407 Enrollment ID: I20130110000013 |
| Provider Name | Krishnakumar R Muthu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407056906 PECOS PAC ID: 7719071182 Enrollment ID: I20131204001742 |
| Provider Name | Linda N Uhegwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336460898 PECOS PAC ID: 4385871615 Enrollment ID: I20131212001049 |
| Provider Name | Marc S Demyun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952366684 PECOS PAC ID: 1254460942 Enrollment ID: I20140206000150 |
| Provider Name | Muhammad S Anwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306073226 PECOS PAC ID: 6901944800 Enrollment ID: I20140311001186 |
| Provider Name | Ambreen Siddiquie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174786107 PECOS PAC ID: 0042378267 Enrollment ID: I20140328000821 |
| Provider Name | Randolph Torres Ramos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619125515 PECOS PAC ID: 0840471652 Enrollment ID: I20140813002280 |
| Provider Name | Luis D Torres |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1386874808 PECOS PAC ID: 6406084755 Enrollment ID: I20150317002786 |
| Provider Name | Rahulkumar G Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780849950 PECOS PAC ID: 5294967345 Enrollment ID: I20151117000506 |
| Provider Name | Adrienn Kovacs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972922748 PECOS PAC ID: 6709153521 Enrollment ID: I20170628000458 |
| Provider Name | Mir M Quadri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235468703 PECOS PAC ID: 2567588874 Enrollment ID: I20170919003620 |
| Provider Name | Ashok K Malhi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053657783 PECOS PAC ID: 3173767316 Enrollment ID: I20180223001235 |
| Provider Name | Asma Hasan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1801041207 PECOS PAC ID: 2466623129 Enrollment ID: I20180801002281 |
| Provider Name | Satyanarayana Chekuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801875083 PECOS PAC ID: 8527037530 Enrollment ID: I20191106001055 |
| Provider Name | Mohsin A Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821393562 PECOS PAC ID: 0143482745 Enrollment ID: I20201228001266 |
| Provider Name | Sri Divya Muppala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457557290 PECOS PAC ID: 1052571460 Enrollment ID: I20210105002175 |
| Provider Name | Biraj Shah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699386888 PECOS PAC ID: 2163837733 Enrollment ID: I20210211001449 |
| Provider Name | Sattar Abdus Sheikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023079209 PECOS PAC ID: 3375713670 Enrollment ID: I20220630001639 |
| Provider Name | Viki Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720485279 PECOS PAC ID: 0840556825 Enrollment ID: I20230222002508 |
| Provider Name | Farha Mahvish |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164829735 PECOS PAC ID: 1052673878 Enrollment ID: I20230406001334 |
| Provider Name | Yugandhara R Devarapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467791160 PECOS PAC ID: 9638306459 Enrollment ID: I20230623001698 |
| Provider Name | Ujwala Gunnal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942557160 PECOS PAC ID: 6204145576 Enrollment ID: I20230925001430 |
| Provider Name | Fnu Anila |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255984068 PECOS PAC ID: 8224445366 Enrollment ID: I20240314001942 |
| Provider Name | Venkataraman Palabindala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114158367 PECOS PAC ID: 3375791312 Enrollment ID: I20240419002313 |
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