MEDICARE: P5 PERFORMANCE 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1366805129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	P5 PERFORMANCE PLLC

Provider Business Mailing Address
First Line	:	9982 CROWN MEADOW DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-0328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9982 CROWN MEADOW DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-0328
Country	:	US
Telephone Number	:	469-600-4100
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	BINDU CHOWRITMOOTOO
Credential	:
Telephone Number	:	469-600-4100

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	03/30/2016

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Directions to “P5 PERFORMANCE PLLC ” Practice Location

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