Organization
CARECONNECT MEDICAL GROUP P.L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAILA GILL (MEDICAL AND HEALTH SERVICES MANAGER)
(254) 498-6671
Entity
Organization
Contact information
Practice address
1600 LAKE SHORE DR APT 121, WACO, TX 76708-3702
(254) 498-6671
Mailing address
1600 LAKE SHORE DR APT 121, WACO, TX 76708-3702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12345678
—
TX
Enumeration date
03/15/2013
Last updated
03/15/2013
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