| Medicos Family Clinic | |
|
1837 N Garland Ave Garland TX 75040-4561 | |
| (469) 432-4107 | |
| Not Available |
| Full Name | Medicos Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1837 N Garland Ave, Garland, Texas |
| Authorized Official Name and Position | Alison Temple (BILLING ADMINISTRATOR) |
| Authorized Official Contact | 8177572902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medicos Family Clinic 1837 N Garland Ave Garland TX 75040-4561 Ph: (469) 432-4107 | Medicos Family Clinic 1837 N Garland Ave Garland TX 75040-4561 Ph: (469) 432-4107 |
| NPI Number | 1528528114 |
|---|---|
| Provider Enumeration Date | 03/21/2019 |
| Last Update Date | 05/08/2019 |
| Medicare PECOS PAC ID | 1658609557 |
|---|---|
| Medicare Enrollment ID | O20190829002165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528528114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Viji P Koduvath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083083364 PECOS PAC ID: 8426353889 Enrollment ID: I20160223000402 |
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