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General NPI Number Information
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NPI Number | 1003212440
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Entity Type | Organization
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Legal Business Name | OMEGA HEIGHTS FAMILY MEDICINE CLINIC PLLC
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 2730 VIRGINIA PKWY SUITE 200
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City | MCKINNEY
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State | TX
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Zip | 75071-5088
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Country | US
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Telephone | 214-491-4900
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Fax | 214-491-4966
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Provider Business Mailing Address
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Address Line | 2730 VIRGINIA PKWY SUITE 200
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City | MCKINNEY
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State | TX
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Zip | 75071-5088
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Country | US
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Telephone | 214-491-4900
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Fax | 214-491-4966
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Authorized Official
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Title or Position | PRESIDENT
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Name | NANETTE ICHO
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Credential | MD
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Telephone | 214-491-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | TX
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