Healthcare Provider Details

I. General information

NPI: 1366908360
Provider Name (Legal Business Name): APEX MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 S PRESTON RD STE 240
PROSPER TX
75078-9835
US

IV. Provider business mailing address

290 S PRESTON RD STE 240
PROSPER TX
75078-9835
US

V. Phone/Fax

Practice location:
  • Phone: 972-378-0383
  • Fax: 972-403-3434
Mailing address:
  • Phone: 972-378-0383
  • Fax: 972-403-3434

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: DR. JADE MALAY
Title or Position: MEMBER
Credential: DC
Phone: 723-780-3839