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Organization
SHALOM GP MEDICAL GROUP LLC
Active
Organization
SHALOM GP MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NKECHINYERE UDENYI MD (MANAGER)
(510) 334-4171
Entity
Organization
Contact information
Practice address
600 C-BAR RANCH TRAIL #89, CEDAR PARK, TX 78613
(510) 334-4171
Mailing address
500 E WHITESTONE BLVD UNIT 3963, CEDAR PARK, TX 78630-4461
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
04/26/2022
Last updated
09/16/2022
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