Healthcare Provider Details

I. General information

NPI: 1407354780
Provider Name (Legal Business Name): CARE WELL TX PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 14TH ST STE T1
PLANO TX
75074-7318
US

IV. Provider business mailing address

4740 14TH ST STE T1
PLANO TX
75074-7318
US

V. Phone/Fax

Practice location:
  • Phone: 469-931-5731
  • Fax:
Mailing address:
  • Phone: 469-931-5731
  • Fax: 469-533-8326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMED S UR REHMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 479-420-5742