Healthcare Provider Details

I. General information

NPI: 1992190714
Provider Name (Legal Business Name): HEKIMIAN TRANSITIONS AND CHRONIC CARE MHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HERITAGE DR SUITE 110
MCKINNEY TX
75069-3256
US

IV. Provider business mailing address

1515 HERITAGE DR SUITE 110
MCKINNEY TX
75069-3256
US

V. Phone/Fax

Practice location:
  • Phone: 972-616-4932
  • Fax:
Mailing address:
  • Phone: 972-616-4932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG5844
License Number StateTX

VIII. Authorized Official

Name: KHOREN HEKIMIAN
Title or Position: OWNER
Credential: DO
Phone: 903-571-6846