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1418 Walkers Way Ste 101 San Antonio TX 78216-7752 | |
| (210) 245-7933 | |
| (210) 761-3824 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 1418 Walkers Way Ste 101, San Antonio, Texas |
| Authorized Official Name and Position | Sujatha Gerineni (MANAGING MEMBER) |
| Authorized Official Contact | 2487664888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2313 Lockhill Selma Rd Ste 102 San Antonio TX 78230-3007 Ph: (210) 245-7933 | 1418 Walkers Way Ste 101 San Antonio TX 78216-7752 Ph: (210) 245-7933 |
| NPI Number | 1295299808 |
|---|---|
| Provider Enumeration Date | 01/28/2019 |
| Last Update Date | 03/08/2024 |
| Medicare PECOS PAC ID | 6305187865 |
|---|---|
| Medicare Enrollment ID | O20190410000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295299808 | NPI | - | NPPES |
| 1295299808 | Other | TX | GROUP NPI |
| 1396973640 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sujatha Gerineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396973640 PECOS PAC ID: 0345495255 Enrollment ID: I20130226000487 |
| Provider Name | Andrea E Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073973020 PECOS PAC ID: 7618276569 Enrollment ID: I20160428000444 |
| Provider Name | Nitendra P Agarwal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497998348 PECOS PAC ID: 9931355823 Enrollment ID: I20170626000335 |
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