| --select-- | |
|
14111 King Rd Ste 320 Frisco TX 75036-8981 | |
| (469) 888-4890 | |
| Not Available |
| Full Name | --select-- |
|---|---|
| Speciality | Internal Medicine |
| Location | 14111 King Rd Ste 320, Frisco, Texas |
| Authorized Official Name and Position | Lata Pablani (MANAGER) |
| Authorized Official Contact | 7188790325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| --select-- 2545 Forest Breeze Dr Frisco TX 75034-0070 Ph: (718) 879-0325 | --select-- 14111 King Rd Ste 320 Frisco TX 75036-8981 Ph: (469) 888-4890 |
| NPI Number | 1225514680 |
|---|---|
| Provider Enumeration Date | 07/18/2018 |
| Last Update Date | 07/01/2022 |
| Medicare PECOS PAC ID | 0244583227 |
|---|---|
| Medicare Enrollment ID | O20181020000029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225514680 | NPI | - | NPPES |
| 1912142985 | Other | NY | NPI |
| Provider Name | Sainath Gaddam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912142985 PECOS PAC ID: 0648435503 Enrollment ID: I20171023002912 |
| Provider Name | Lata Pablani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356586937 PECOS PAC ID: 5890938138 Enrollment ID: I20181020000108 |
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