| Dfw Geriatrics Pllc | |
|
2925 Skyway Cir N Irving TX 75038-3510 | |
| (972) 639-5838 | |
| (972) 791-8211 |
| Full Name | Dfw Geriatrics Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2925 Skyway Cir N, Irving, Texas |
| Authorized Official Name and Position | Sumana Ketha (PRESIDENT) |
| Authorized Official Contact | 9726395838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfw Geriatrics Pllc 2925 Skyway Cir N Irving TX 75038-3510 Ph: (972) 639-5838 | Dfw Geriatrics Pllc 2925 Skyway Cir N Irving TX 75038-3510 Ph: (972) 639-5838 |
| NPI Number | 1063835361 |
|---|---|
| Provider Enumeration Date | 01/23/2014 |
| Last Update Date | 02/04/2020 |
| Medicare PECOS PAC ID | 8628201498 |
|---|---|
| Medicare Enrollment ID | O20140501000314 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063835361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 253Z00000X | In Home Supportive Care | (Texas) | Secondary |
| Provider Name | Sumana Ketha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962447805 PECOS PAC ID: 9032199468 Enrollment ID: I20040724000335 |
| Provider Name | Derrick M Love-jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952728636 PECOS PAC ID: 2466676952 Enrollment ID: I20140625000071 |
| Provider Name | Rina Sarkar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073558433 PECOS PAC ID: 0840265138 Enrollment ID: I20180511000815 |
| Provider Name | Kopila Gopali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487138202 PECOS PAC ID: 3971901216 Enrollment ID: I20211018001135 |
| Provider Name | Sapana Gurung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629773882 PECOS PAC ID: 3870950595 Enrollment ID: I20230612000099 |
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