Provider Demographics
NPI:1073968517
Name:ELITE INTERNS PLLC
Entity Type:Organization
Organization Name:ELITE INTERNS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKARANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-479-9260
Mailing Address - Street 1:8067 W VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3767
Mailing Address - Country:US
Mailing Address - Phone:972-230-5601
Mailing Address - Fax:
Practice Address - Street 1:8067 W VIRGINIA DR STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3767
Practice Address - Country:US
Practice Address - Phone:972-230-5601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0505261QP2300X
TXN8334261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care