| Premier Houston Area Family Medical Clinics | |
|
2211 A E. Broadway Pearland TX 77581 | |
| (281) 485-6144 | |
| (281) 485-6146 |
| Full Name | Premier Houston Area Family Medical Clinics |
|---|---|
| Speciality | Family Medicine |
| Location | 2211 A E. Broadway, Pearland, Texas |
| Authorized Official Name and Position | Marie D. Mengarelli (CREDENTIALING) |
| Authorized Official Contact | 7139466081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Houston Area Family Medical Clinics 2211 A E. Broadway Pearland TX 77581 Ph: (281) 485-6144 | Premier Houston Area Family Medical Clinics 2211 A E. Broadway Pearland TX 77581 Ph: (281) 485-6144 |
| NPI Number | 1669412250 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 07/12/2010 |
| Medicare PECOS PAC ID | 9335138510 |
|---|---|
| Medicare Enrollment ID | O20040511001785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669412250 | NPI | - | NPPES |
| 080069001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | F5827 (Texas) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | F5827 (Texas) | Secondary |
| Provider Name | Rodney M Wiseman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508832999 PECOS PAC ID: 0840273470 Enrollment ID: I20040612000386 |
| Provider Name | Palur V Balakrishnan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679508485 PECOS PAC ID: 8325037518 Enrollment ID: I20051104000392 |
| Provider Name | Brandi J Pipes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053514778 PECOS PAC ID: 1557447984 Enrollment ID: I20080326000544 |
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