Healthcare Provider Details

I. General information

NPI: 1437676640
Provider Name (Legal Business Name): PREMIER INDEPENDENT PHYSICIANS GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 TEASLEY LN
DENTON TX
76205-7282
US

IV. Provider business mailing address

2871 LAKE VISTA DR STE 210
LEWISVILLE TX
75067-8411
US

V. Phone/Fax

Practice location:
  • Phone: 940-442-5209
  • Fax: 940-222-2720
Mailing address:
  • Phone: 940-442-5209
  • Fax: 940-222-2720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CAROL NGUYEN
Title or Position: COO
Credential:
Phone: 940-565-0800