| Prime Medic Network, Pllc | |
|
211 S College Ave Cleveland TX 77327-4503 | |
| (281) 592-8622 | |
| (281) 592-8699 |
| Full Name | Prime Medic Network, Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 211 S College Ave, Cleveland, Texas |
| Authorized Official Name and Position | Sreenivasulu Cherlo (OWNER) |
| Authorized Official Contact | 2815928622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Medic Network, Pllc Po Box 5999 Kingwood TX 77325-5999 Ph: (281) 592-8622 | Prime Medic Network, Pllc 211 S College Ave Cleveland TX 77327-4503 Ph: (281) 592-8622 |
| NPI Number | 1114477445 |
|---|---|
| Provider Enumeration Date | 10/11/2016 |
| Last Update Date | 10/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114477445 | NPI | - | NPPES |
| 111766506 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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