| Live Well Medical Care Pllc | |
|
150 Pine Forest Dr Ste 602 Shenandoah TX 77384-5304 | |
| (281) 819-7869 | |
| (832) 730-4494 |
| Full Name | Live Well Medical Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 150 Pine Forest Dr Ste 602, Shenandoah, Texas |
| Authorized Official Name and Position | Madhavi Machineni (CEO) |
| Authorized Official Contact | 2149060204 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Well Medical Care Pllc 12945 Lake Parc Bend Dr Cypress TX 77429-6192 Ph: (281) 819-7869 | Live Well Medical Care Pllc 150 Pine Forest Dr Ste 602 Shenandoah TX 77384-5304 Ph: (281) 819-7869 |
| NPI Number | 1225525843 |
|---|---|
| Provider Enumeration Date | 04/19/2018 |
| Last Update Date | 05/08/2019 |
| Medicare PECOS PAC ID | 9931464914 |
|---|---|
| Medicare Enrollment ID | O20180522000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225525843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | P3120 (* (Not Available)) | Primary |
| Provider Name | Madhavi Machineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992930929 PECOS PAC ID: 2567611148 Enrollment ID: I20120926000458 |
| Provider Name | Kristine Michelle Clements |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750750428 PECOS PAC ID: 9436469822 Enrollment ID: I20160122000123 |
| Provider Name | Lenah Eva Ngombo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255092938 PECOS PAC ID: 2860879285 Enrollment ID: I20220524001325 |
| Provider Name | Bohui Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760129613 PECOS PAC ID: 6103292438 Enrollment ID: I20221012000027 |
| Provider Name | Reshemma Dion Nard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497363295 PECOS PAC ID: 0547611121 Enrollment ID: I20240108005078 |
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