| Tennessee Family Doctors, Pllc | |
|
1195 Old Hickory Blvd Suite 103 Brentwood TN 37027-4239 | |
| (615) 373-2000 | |
| (615) 891-5021 |
| Full Name | Tennessee Family Doctors, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1195 Old Hickory Blvd, Brentwood, Tennessee |
| Authorized Official Name and Position | Sreedhar Samudrala (OWNER) |
| Authorized Official Contact | 6153732000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tennessee Family Doctors, Pllc 1195 Old Hickory Blvd Suite 103 Brentwood TN 37027-4239 Ph: (615) 373-2000 | Tennessee Family Doctors, Pllc 1195 Old Hickory Blvd Suite 103 Brentwood TN 37027-4239 Ph: (615) 373-2000 |
| NPI Number | 1629035654 |
|---|---|
| Provider Enumeration Date | 04/26/2006 |
| Last Update Date | 05/15/2014 |
| Medicare PECOS PAC ID | 6305821877 |
|---|---|
| Medicare Enrollment ID | O20040619000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629035654 | NPI | - | NPPES |
| 3377514 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD0000036148 (Tennessee) | Primary |
| Provider Name | Sreedhar Samudrala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083689566 PECOS PAC ID: 9537145339 Enrollment ID: I20040726001305 |
| Provider Name | Renee N Dhillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952396921 PECOS PAC ID: 1456328475 Enrollment ID: I20040910000363 |
| Provider Name | Sadia M Dar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326115577 PECOS PAC ID: 7517064249 Enrollment ID: I20100526000150 |
| Provider Name | Teri Mcclain-watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609252659 PECOS PAC ID: 7416251087 Enrollment ID: I20160203000123 |
| Provider Name | Helene Angeline Fodra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841833951 PECOS PAC ID: 7113351073 Enrollment ID: I20191231000670 |
| Provider Name | Prathana Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518610443 PECOS PAC ID: 8123412632 Enrollment ID: I20220228000352 |
| Provider Name | Beth Ann Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568138865 PECOS PAC ID: 1759774417 Enrollment ID: I20220804001906 |
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