| Krc Memory Care PLLC | |
|
8198 Walnut Hill Ln Ste 100 Dallas TX 75231-4316 | |
| (972) 433-9100 | |
| (214) 583-2278 |
| Full Name | Krc Memory Care PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 8198 Walnut Hill Ln Ste 100, Dallas, Texas |
| Authorized Official Name and Position | Taylor Harris (OFFICE MANAGER) |
| Authorized Official Contact | 9724339155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Krc Memory Care PLLC 8198 Walnut Hill Ln Ste 100 Dallas TX 75231-4316 Ph: (972) 433-9100 | Krc Memory Care PLLC 8198 Walnut Hill Ln Ste 100 Dallas TX 75231-4316 Ph: (972) 433-9100 |
| NPI Number | 1144898651 |
|---|---|
| Provider Enumeration Date | 06/12/2021 |
| Last Update Date | 06/12/2021 |
| Certification Date | 06/12/2021 |
| Medicare PECOS PAC ID | 0143691311 |
|---|---|
| Medicare Enrollment ID | O20230126000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144898651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (NU) | Primary |
| Provider Name | Andrea Lynn Hester |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699009407 PECOS PAC ID: 7214074889 Enrollment ID: I20091030000297 |
| Provider Name | Diana Kerwin |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1750335097 PECOS PAC ID: 4789633421 Enrollment ID: I20130807000512 |
| Provider Name | Irmaris Rios-vazquez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285197525 PECOS PAC ID: 5597007047 Enrollment ID: I20190502000622 |
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