MEDICARE: MC HEALTHCARE PA

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1295053973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MC HEALTHCARE PA

Provider Business Mailing Address
First Line	:	3044 OLD DENTON RD STE 317
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5017
Country	:	US
Telephone Number	:	972-242-4440
Fax Number	:	972-242-4949

Provider Business Practice Location Address
First Line	:	3044 OLD DENTON RD STE 317
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5017
Country	:	US
Telephone Number	:	972-242-4440
Fax Number	:	972-242-4949

Authorized Official
Title or Position	:	OWNER
Name	:	SHAHRIAR SETOUDEH-MARAM
Credential	:	MD
Telephone Number	:	214-585-3969

Provider Enumeration Date	:	05/05/2010
Last Update Date	:	03/19/2014

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Directions to “MC HEALTHCARE PA ” Practice Location

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