Healthcare Provider Details

I. General information

NPI: 1700423738
Provider Name (Legal Business Name): ESPLANADE MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 W 15TH ST # F-366
PLANO TX
75075-7363
US

IV. Provider business mailing address

2024 W 15TH ST # F-366
PLANO TX
75075-7363
US

V. Phone/Fax

Practice location:
  • Phone: 214-817-4226
  • Fax: 469-754-0416
Mailing address:
  • Phone: 972-370-5771
  • Fax: 469-754-0416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMEER SYED
Title or Position: ADMIN
Credential:
Phone: 972-370-5771