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Organization
PRIME MEDIC, P.A.
Active
Organization
PRIME MEDIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SREENIVASULU CHERLO M.D. (CEO)
(281) 592-8622
Entity
Organization
Contact information
Practice address
211 S COLLEGE AVE, CLEVELAND, TX 77327-4503
(281) 592-8622
(281) 592-8699
Mailing address
PO BOX 5999, KINGWOOD, TX 77325-5999
(281) 592-8622
(281) 592-8699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K1393
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161613801
—
TX
Enumeration date
09/26/2006
Last updated
01/20/2012
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