Healthcare Provider Details

I. General information

NPI: 1972037307
Provider Name (Legal Business Name): MORRISON MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 TOWN AND COUNTRY BLVD STE 155
FRISCO TX
75034-6949
US

IV. Provider business mailing address

11816 INWOOD RD # 70266
DALLAS TX
75244-8011
US

V. Phone/Fax

Practice location:
  • Phone: 972-656-9532
  • Fax: 847-787-1437
Mailing address:
  • Phone: 972-656-9532
  • Fax: 847-787-1437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA04169
License Number StateTX

VIII. Authorized Official

Name: MRS. AMY MORRISON
Title or Position: OWNER
Credential: PA
Phone: 214-450-4035