Organization
SKILLED PRIMARY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVEK SASTRY M.D. (PRESIDENT)
(972) 668-5400
Entity
Organization
Contact information
Practice address
7460 WARREN PKWY, STE. 160, FRISCO, TX 75034-4169
(972) 668-5400
(972) 668-5401
Mailing address
PO BOX 2306, FRISCO, TX 75034-0042
(972) 668-5400
(972) 668-5401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214797702
—
TX
01
—
DQ5280
RR MEDICARE
TX
Enumeration date
04/08/2010
Last updated
06/24/2011
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