Healthcare Provider Details

I. General information

NPI: 1487817151
Provider Name (Legal Business Name): INTERNAL MEDICINE ASSOCIATES OF PLANO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6124 W PARKER RD MOB III SUITE 234
PLANO TX
75093-8124
US

IV. Provider business mailing address

6124 W PARKER RD MOB III SUITE 234
PLANO TX
75093-8124
US

V. Phone/Fax

Practice location:
  • Phone: 972-981-7500
  • Fax: 972-981-3600
Mailing address:
  • Phone: 972-981-7500
  • Fax: 972-981-3600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberM6414
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberN7347
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberH6269
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK3141
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberK7510
License Number StateTX

VIII. Authorized Official

Name: MRS. PATRICIA CORTEZ
Title or Position: PRACTICE MANAGER
Credential:
Phone: 972-815-6856