MEDICARE: PPG HEALTH, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	204F00000X	Transplant Surgery Physician
2	207N00000X	Dermatology Physician
3	207Q00000X	Family Medicine Physician
4	207R00000X	Internal Medicine Physician
5	207RC0000X	Cardiovascular Disease Physician
6	207RC0001X	Clinical Cardiac Electrophysiology Physician
7	207RG0100X	Gastroenterology Physician
8	207RI0011X	Interventional Cardiology Physician
9	207RT0003X	Transplant Hepatology Physician
10	207V00000X	Obstetrics & Gynecology Physician
11	208600000X	Surgery Physician
12	2086X0206X	Surgical Oncology Physician
13	363A00000X	Physician Assistant
14	363L00000X	Nurse Practitioner
15	207RN0300X	Nephrology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00QQ28	OTHER	TX	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295736973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PPG HEALTH, PA

Provider Business Mailing Address
First Line	:	1000 W CANNON ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3029
Country	:	US
Telephone Number	:	817-877-5858
Fax Number	:	817-335-4418

Provider Business Practice Location Address
First Line	:	1000 W CANNON ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3029
Country	:	US
Telephone Number	:	817-877-5858
Fax Number	:	817-335-4418

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. PONNIAH S SANKARAPANDIAN
Credential	:	MD
Telephone Number	:	817-877-5858

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	04/02/2025

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Directions to “PPG HEALTH, PA ” Practice Location

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