Healthcare Provider Details

I. General information

NPI: 1164797791
Provider Name (Legal Business Name): ACUTE KIDS URGENT CARE OF MEDICAL CITY CHILDREN'S HOSPITAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 DALLAS PKWY SUITE 345
PLANO TX
75093
US

IV. Provider business mailing address

PO BOX 742091
ATLANTA GA
30374-2091
US

V. Phone/Fax

Practice location:
  • Phone: 972-300-4200
  • Fax: 972-300-4201
Mailing address:
  • Phone: 972-745-7500
  • Fax: 972-745-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RHONDA MCKINNEY
Title or Position: AVP REVENUE CYCLE URGENT CARE
Credential:
Phone: 972-906-8107