| Chandan Mazumder, MD | |
|
1900 W Wall St Ste C, Midland, TX 79701-6568 | |
| (432) 221-2500 | |
| (432) 687-1914 |
| Full Name | Chandan Mazumder |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1900 W Wall St Ste C, Midland, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093928913 | NPI | - | NPPES |
| 279640600 | Medicaid | FL | |
| 305512101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | ME 98432 (Florida) | Secondary |
| 208000000X | Pediatrics | P3771 (Texas) | Primary |
| Entity Name | Premier Family Care I, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275522864 PECOS PAC ID: 2567351372 Enrollment ID: O20040311000343 |
| Entity Name | Midland Community Healthcare Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235225087 PECOS PAC ID: 0345230975 Enrollment ID: O20040515000364 |
| Mailing Address | Practice Location Address |
|---|---|
| Chandan Mazumder, MD 4214 Andrews Hwy Ste 240, Midland, TX 79703-4817 Ph: (432) 686-6605 | Chandan Mazumder, MD 1900 W Wall St Ste C, Midland, TX 79701-6568 Ph: (432) 221-2500 |
Mohammed Hussein Nasser Aljarwi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4214 Andrews Hwy Ste 102, Midland, TX 79703 Phone: 432-256-4390 Fax: 432-256-4391 | |
Dr. Wellington F Ballesteros, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 Delano Ave, Midland, TX 79701 Phone: 432-697-4747 Fax: 432-699-3813 | |
Nidhi Girishchandra Shah, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4214 Andrews Hwy Ste 310, Midland, TX 79703 Phone: 432-697-4747 Fax: 432-699-3813 | |
Jennifer Blackerby, Pediatrics Medicare: Medicare Enrolled Practice Location: 5000 Briarwood Ave, Midland, TX 79707 Phone: 432-682-5385 | |
Kranthi Nandan Seelaboyina, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 316 Secor St, Midland, TX 79701 Phone: 432-620-1111 Fax: 432-620-1112 | |
Megan Breanne Rossman, PA-C Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 302 Secor St, Midland, TX 79701 Phone: 432-685-5029 |