Healthcare Provider Details

I. General information

NPI: 1306727318
Provider Name (Legal Business Name): CONCEPT HEALTH CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 W CAMPBELL RD STE 304
RICHARDSON TX
75080-3620
US

IV. Provider business mailing address

399 W CAMPBELL ROAD SUITE 304
RICHARDSON TX
75080-3620
US

V. Phone/Fax

Practice location:
  • Phone: 972-235-2304
  • Fax: 972-235-8442
Mailing address:
  • Phone: 972-235-2304
  • Fax: 972-235-8442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAFAY LATIF
Title or Position: PRESIDENT
Credential: MD/MHA
Phone: 972-235-2304