| Dallas Geriatrics Associates, P.a | |
|
4200 Shepherd Ln Balch Springs TX 75180-3423 | |
| (214) 325-1969 | |
| (972) 291-0019 |
| Full Name | Dallas Geriatrics Associates, P.a |
|---|---|
| Speciality | Family Medicine |
| Location | 4200 Shepherd Ln, Balch Springs, Texas |
| Authorized Official Name and Position | Jyotsna S Prasad (PRESIDENT) |
| Authorized Official Contact | 9729000747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Geriatrics Associates, P.a 445 E. Fm 1382 Suite # 3354 Cedar Hill TX 75104 Ph: (972) 900-0747 | Dallas Geriatrics Associates, P.a 4200 Shepherd Ln Balch Springs TX 75180-3423 Ph: (214) 325-1969 |
| NPI Number | 1629258058 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 08/04/2022 |
| Medicare PECOS PAC ID | 1355425695 |
|---|---|
| Medicare Enrollment ID | O20080226000581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629258058 | NPI | - | NPPES |
| 00Y540 | Other | TX | GROUP PTAN/ DALLAS COUNTY |
| H75575 | Other | TX | MEDICARE UPIN |
| L5100 | Other | TX | TEXAS MEDICAL LICENSE # |
| 00Y542 | Other | TX | GROUP PTAN/ TARRANT COUNTY |
| 00Y541 | Other | TX | GROUP PTAN/ ELLIS & TARRANT COUNTY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | J6213 (Texas) | Secondary |
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Kimberly Neely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841239738 PECOS PAC ID: 5698765204 Enrollment ID: I20040515000194 |
| Provider Name | Tina L Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689698243 PECOS PAC ID: 3577546852 Enrollment ID: I20040608001329 |
| Provider Name | Jyotsna S Prasad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477571883 PECOS PAC ID: 4284686429 Enrollment ID: I20050215001066 |
Foremost Family Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3515 Shepherd Ln, Balch Springs, TX 75180 Phone: 972-588-4532 Fax: 214-888-3149 | |
Michael D. Fulton, D.o., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3515 Shepherd Ln, Balch Springs, TX 75180 Phone: 972-913-0200 Fax: 972-913-8094 |