| Prime Medic, P.a. | |
|
211 S College Ave Cleveland TX 77327-4503 | |
| (281) 592-8622 | |
| (281) 592-8699 |
| Full Name | Prime Medic, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 211 S College Ave, Cleveland, Texas |
| Authorized Official Name and Position | Sreenivasulu Cherlo (CEO) |
| Authorized Official Contact | 2815928622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Medic, P.a. Po Box 5999 Kingwood TX 77325-5999 Ph: (281) 592-8622 | Prime Medic, P.a. 211 S College Ave Cleveland TX 77327-4503 Ph: (281) 592-8622 |
| NPI Number | 1255432829 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 01/20/2012 |
| Medicare PECOS PAC ID | 7012958754 |
|---|---|
| Medicare Enrollment ID | O20050512000763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255432829 | NPI | - | NPPES |
| 161613801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K1393 (Texas) | Primary |
| Provider Name | Martin G Perez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477693794 PECOS PAC ID: 1254382567 Enrollment ID: I20050203000684 |
| Provider Name | Ahmed K Qadri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982701298 PECOS PAC ID: 6406958107 Enrollment ID: I20070227000471 |
| Provider Name | Sandra Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154507242 PECOS PAC ID: 0345307658 Enrollment ID: I20090331000280 |
| Provider Name | Anand Basi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639270291 PECOS PAC ID: 5092843128 Enrollment ID: I20100512000092 |
| Provider Name | Sreenivasulu Cherlo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578664116 PECOS PAC ID: 9537297569 Enrollment ID: I20100512000110 |
| Provider Name | Mary Casebolt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588933774 PECOS PAC ID: 1254599103 Enrollment ID: I20151209000451 |
| Provider Name | Hemlata Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407488547 PECOS PAC ID: 1052748977 Enrollment ID: I20200305000284 |
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