Healthcare Provider Details

I. General information

NPI: 1316632540
Provider Name (Legal Business Name): A1 MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 STONEBROOK PKWY UNIT 201A
FRISCO TX
75036-1181
US

IV. Provider business mailing address

400 STONEBROOK PKWY UNIT 201A
FRISCO TX
75036-1181
US

V. Phone/Fax

Practice location:
  • Phone: 214-387-1888
  • Fax: 214-387-1889
Mailing address:
  • Phone: 214-387-1888
  • Fax: 214-387-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHEEBA MATHAI
Title or Position: DIRECTOR
Credential: APRN, FNP-BC
Phone: 972-313-5017