MEDICARE: COMPLETE INFECTIOUS DISEASES CARE ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	P6399	TX

General Provider Information

NPI Number	:	1417447012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE INFECTIOUS DISEASES CARE ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 1841
Second Line	:
City	:	COLLEYVILLE
State	:	TX
Zip	:	76034-1841
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11803 SOUTH FWY STE 202
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-7029
Country	:	US
Telephone Number	:	646-244-8857
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VITALY GOLUB
Credential	:	MD
Telephone Number	:	646-244-8857

Provider Enumeration Date	:	05/18/2018
Last Update Date	:	05/18/2018

Similar Medicare Providers

1053382754 — DR. PRAKASH HEGDE MD
Practice Location Address:

11803 SOUTH FWY STE 201
BURLESON, TX
76028-7029

Practice Phone: 817-293-4800
Practice Fax: 817-293-4808

1457399115 — NORTH EAST HOSPITALIST MANAGEMENT, INC
Practice Location Address:

11803 SOUTH FWY STE 201
BURLESON, TX
76028-7029

Practice Phone: 817-293-4800
Practice Fax: 817-293-4808

1013852938 — AIMEE HARRIS
Practice Location Address:

11801 SOUTH FWY
BURLESON, TX
76028-7021

Practice Phone: 817-293-9110
Practice Fax:

1962348870 — BRIANA NIKHOL STEELE OTR
Practice Location Address:

621 OLD HIGHWAY 1187
BURLESON, TX
76028-7756

Practice Phone: 817-293-2300
Practice Fax:

1891639415 — DIANA A CROWELL
Practice Location Address:

12517 VIEWPOINT LN
BURLESON, TX
76028-7069

Practice Phone: 972-824-3768
Practice Fax:

1710672373 — ERIC ARDEEN BORTNEM DMD, MS
Practice Location Address:

809 SW ALSBURY BLVD # 100
BURLESON, TX
76028-9200

Practice Phone: 817-426-1406
Practice Fax:

Directions to “COMPLETE INFECTIOUS DISEASES CARE ASSOCIATES, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.