| Everly Provider Group Ny | |
|
5209 Burnet Rd Unit 300 Austin TX 78756-2443 | |
| (855) 422-3855 | |
| Not Available |
| Full Name | Everly Provider Group Ny |
|---|---|
| Speciality | General Practice |
| Location | 5209 Burnet Rd Unit 300, Austin, Texas |
| Authorized Official Name and Position | Saba Haq (AO) |
| Authorized Official Contact | 9494630650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Everly Provider Group Ny 5209 Burnet Rd Unit 300 Austin TX 78756-2443 | Everly Provider Group Ny 5209 Burnet Rd Unit 300 Austin TX 78756-2443 Ph: (855) 422-3855 |
| NPI Number | 1508605973 |
|---|---|
| Provider Enumeration Date | 05/23/2024 |
| Last Update Date | 06/03/2026 |
| Certification Date | 06/03/2026 |
| Medicare PECOS PAC ID | 0941749782 |
|---|---|
| Medicare Enrollment ID | O20251205002302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508605973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Monica Amona Martin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417904962 PECOS PAC ID: 9537258710 Enrollment ID: I20071211000657 |
| Provider Name | Katherine Richey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407264625 PECOS PAC ID: 3779705900 Enrollment ID: I20141104000463 |
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