Individual ProviderEzhil PanneerselvamInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4801 Alberta Ave, El Paso, TX 79905-2707(843) 597-3010PECOS EnrollmentBased on the most recent information from CMS, provider Ezhil Panneerselvam is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1235794546Provider TypeIndividualFull NamePanneerselvam, EzhilCredentialMDGenderMaleSole ProprietorNoEnumeration Date5/2/2019Last Updated6/6/2023Contact InformationPractice LocationPractice Address4801 Alberta Ave, El Paso, TX 79905-2707Phone(843) 597-3010FaxUnlisted FaxMailing LocationMailing Address4801 Alberta Ave, El Paso, TX 79905-2707PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseT9768TexasCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer