| Blue Lotus Medical Group Llc | |
|
7600 Chevy Chase Dr Ste 300 Austin TX 78752-1599 | |
| (817) 910-6711 | |
| (800) 915-0474 |
| Full Name | Blue Lotus Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7600 Chevy Chase Dr Ste 300, Austin, Texas |
| Authorized Official Name and Position | David Mcclure (CEO) |
| Authorized Official Contact | 8176820341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Lotus Medical Group Llc 7600 Chevy Chase Dr Ste 300 Austin TX 78752-1599 Ph: (817) 910-6711 | Blue Lotus Medical Group Llc 7600 Chevy Chase Dr Ste 300 Austin TX 78752-1599 Ph: (817) 910-6711 |
| NPI Number | 1578309852 |
|---|---|
| Provider Enumeration Date | 07/05/2024 |
| Last Update Date | 02/19/2026 |
| Medicare PECOS PAC ID | 7113458522 |
|---|---|
| Medicare Enrollment ID | O20241009000460 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578309852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Secondary |
| Provider Name | John G. Preddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922064955 PECOS PAC ID: 5698890192 Enrollment ID: I20121017000925 |
| Provider Name | Hermanjeet S Grewal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871881300 PECOS PAC ID: 3678799004 Enrollment ID: I20141216000943 |
| Provider Name | Crystal Maldonado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972019115 PECOS PAC ID: 4183985948 Enrollment ID: I20180220000065 |
| Provider Name | Shanna Renee Fraser |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1316451594 PECOS PAC ID: 3173949609 Enrollment ID: I20200814001272 |
| Provider Name | Vanessa Mercedes Villarreal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194430819 PECOS PAC ID: 6901261304 Enrollment ID: I20230508000328 |
| Provider Name | Surelis Yolanda Martinez Cantillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801629837 PECOS PAC ID: 7214468743 Enrollment ID: I20241008001385 |
| Provider Name | Ariel Beckey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720745425 PECOS PAC ID: 0840630901 Enrollment ID: I20241028003836 |
| Provider Name | Johnny Ray Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336824721 PECOS PAC ID: 1759516388 Enrollment ID: I20241115004041 |
Harold D Lewis Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 West William Cannon Drive, Suite 123, Austin, TX 78745 Phone: 512-444-2661 Fax: 512-444-2720 | |
Julie Graves Moy Md Mph Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8127 Mesa Dr, B206-54, Austin, TX 78759 Phone: 512-689-8001 | |
Edie E. Shulman M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11673 Jollyville Rd., Suite B-101, Austin, TX 78759 Phone: 512-339-1535 Fax: 512-339-1526 | |
El Buen Samaritano Episcopal Mission Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7000 Woodhue Dr, Austin, TX 78745 Phone: 512-439-0701 | |
Occupational Health Centers Of The Southwest P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10001 S Ih 35 Ste 300, Austin, TX 78747 Phone: 512-440-0555 Fax: 214-775-4502 | |
Tmc Provider Group Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9900 S Ih 35, Austin, TX 78748 Phone: 512-291-5577 Fax: 512-291-5576 | |
Doctx3 Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 709 E Slaughter Ln Ste 404, Austin, TX 78744 Phone: 469-277-8253 |