Healthcare Provider Details

I. General information

NPI: 1740888080
Provider Name (Legal Business Name): AMERI MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2301 MARSH LN STE 600
PLANO TX
75093-8497
US

IV. Provider business mailing address

2301 MARSH LN STE 600
PLANO TX
75093-8497
US

V. Phone/Fax

Practice location:
  • Phone: 972-798-8100
  • Fax: 214-291-5702
Mailing address:
  • Phone: 972-798-8100
  • Fax: 214-291-5702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTINA BARRETT
Title or Position: PROGRAM MANAGER
Credential: RN
Phone: 972-798-8100