| 1960 Physician Associates | |
|
837 Cypress Creek Pkwy Suite 105 Houston TX 77090-3423 | |
| (281) 453-2585 | |
| (281) 440-2020 |
| Full Name | 1960 Physician Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 837 Cypress Creek Pkwy, Houston, Texas |
| Authorized Official Name and Position | Jennifer Sydenham (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8327039060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 1960 Physician Associates 837 Cypress Creek Pkwy Ste 105 Houston TX 77090-3422 Ph: (281) 586-3888 | 1960 Physician Associates 837 Cypress Creek Pkwy Suite 105 Houston TX 77090-3423 Ph: (281) 453-2585 |
| NPI Number | 1215391941 |
|---|---|
| Provider Enumeration Date | 04/08/2016 |
| Last Update Date | 01/07/2020 |
| Medicare PECOS PAC ID | 1153611975 |
|---|---|
| Medicare Enrollment ID | O20160608000027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215391941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | John P Lacson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053498287 PECOS PAC ID: 8426943044 Enrollment ID: I20040224000555 |
| Provider Name | Henry J Grainger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306892005 PECOS PAC ID: 0446146898 Enrollment ID: I20040224000823 |
| Provider Name | Syed N Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255378352 PECOS PAC ID: 7315837879 Enrollment ID: I20040318000100 |
| Provider Name | Lynanne J Foster |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326059106 PECOS PAC ID: 3476533613 Enrollment ID: I20040720001222 |
| Provider Name | Pulin K Pandya |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558330498 PECOS PAC ID: 2769440528 Enrollment ID: I20041227000340 |
| Provider Name | Prabhugouda B Patil |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619157492 PECOS PAC ID: 2365400017 Enrollment ID: I20050815000310 |
| Provider Name | Joseph Varon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1215983895 PECOS PAC ID: 6507859527 Enrollment ID: I20070531000513 |
| Provider Name | Hans H Truong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518958271 PECOS PAC ID: 3577511187 Enrollment ID: I20071226000510 |
| Provider Name | Ramarao M Denduluri |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982620373 PECOS PAC ID: 1658438338 Enrollment ID: I20090324000677 |
| Provider Name | Abdul Ali |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598734121 PECOS PAC ID: 4385602986 Enrollment ID: I20091217000682 |
| Provider Name | Darlene M Miltenburg |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982664413 PECOS PAC ID: 3971646506 Enrollment ID: I20100204000694 |
| Provider Name | Carlos Reynaldo Herrera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003858143 PECOS PAC ID: 4880721687 Enrollment ID: I20100428000113 |
| Provider Name | Shakeel Uddin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548260029 PECOS PAC ID: 4789757873 Enrollment ID: I20100429001199 |
| Provider Name | Alan P Glombicki |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669467395 PECOS PAC ID: 6800980749 Enrollment ID: I20101008001105 |
| Provider Name | Richard Nuila Crouse |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205840766 PECOS PAC ID: 7911034012 Enrollment ID: I20101130001379 |
| Provider Name | Jorge Guerrero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912015975 PECOS PAC ID: 8628175601 Enrollment ID: I20110107000561 |
| Provider Name | Sharad Sharma |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1831229152 PECOS PAC ID: 1951406792 Enrollment ID: I20110429000422 |
| Provider Name | Jose W Aguirre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205086311 PECOS PAC ID: 6305024241 Enrollment ID: I20110624000247 |
| Provider Name | Srijaya Bandi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295907525 PECOS PAC ID: 2365615168 Enrollment ID: I20111021000393 |
| Provider Name | Paul E Kobza |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114932845 PECOS PAC ID: 1850289471 Enrollment ID: I20120112000206 |
| Provider Name | Ronald Alan Buczek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962448811 PECOS PAC ID: 6608764212 Enrollment ID: I20121031000597 |
| Provider Name | Robert W Van Boven |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316000326 PECOS PAC ID: 6305744608 Enrollment ID: I20130920000772 |
| Provider Name | Douglas W Lacour |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245231398 PECOS PAC ID: 3072737907 Enrollment ID: I20140617000417 |
| Provider Name | Wilson Arturo Almonte |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1255566642 PECOS PAC ID: 5496973208 Enrollment ID: I20140820000317 |
| Provider Name | Michele L Thornhill |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1598150849 PECOS PAC ID: 5496074841 Enrollment ID: I20150506000977 |
| Provider Name | Tariq Hussain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588061030 PECOS PAC ID: 7416261839 Enrollment ID: I20150729009657 |
| Provider Name | Gita D Meshri |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053560011 PECOS PAC ID: 4183859333 Enrollment ID: I20151117000259 |
| Provider Name | Victor Ivan Escobar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184983496 PECOS PAC ID: 7517268923 Enrollment ID: I20151208003187 |
| Provider Name | Yasir Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023308210 PECOS PAC ID: 2567772288 Enrollment ID: I20160407002218 |
| Provider Name | Gregory Vidovic |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1548602212 PECOS PAC ID: 1557653755 Enrollment ID: I20160708000760 |
| Provider Name | Syed B Sadiq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639309685 PECOS PAC ID: 8224250147 Enrollment ID: I20170123000667 |
| Provider Name | Salim K Durrani |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1003105065 PECOS PAC ID: 3072889781 Enrollment ID: I20171025001293 |
| Provider Name | Amir Azeem |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1265526339 PECOS PAC ID: 0446354237 Enrollment ID: I20180109000232 |
| Provider Name | Sajid Asim Ali |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750693248 PECOS PAC ID: 1557503869 Enrollment ID: I20180710001109 |
| Provider Name | Zubair B Mirza |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1245543578 PECOS PAC ID: 4688812712 Enrollment ID: I20180917000264 |
| Provider Name | Stacey Ann Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366940322 PECOS PAC ID: 2567708886 Enrollment ID: I20190108001431 |
| Provider Name | Ra'kerry Kahlil Rahman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972752228 PECOS PAC ID: 2961673082 Enrollment ID: I20190424000241 |
| Provider Name | Arshad A Khan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114977907 PECOS PAC ID: 8022081603 Enrollment ID: I20190528000750 |
| Provider Name | Alfonso E Reyes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225112659 PECOS PAC ID: 3779503834 Enrollment ID: I20190627003443 |
| Provider Name | Daljit Kaur Bagha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225188162 PECOS PAC ID: 0042314023 Enrollment ID: I20200129000904 |
| Provider Name | Muhammod Ahmad |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1992745806 PECOS PAC ID: 8224058136 Enrollment ID: I20200303002225 |
| Provider Name | Trevor Martin Cobb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427606763 PECOS PAC ID: 5991133571 Enrollment ID: I20200313000206 |
| Provider Name | Talal Zahoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912352162 PECOS PAC ID: 8022304054 Enrollment ID: I20210517001860 |
| Provider Name | Daniel Costa Garcia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043586159 PECOS PAC ID: 6204257686 Enrollment ID: I20210921001012 |
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