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General NPI Number Information
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NPI Number | 1134406028
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Entity Type | Organization
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Legal Business Name | PLAZA MEDICAL CENTER
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Dates
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Enumeration Date | 11/07/2011
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Last Update Date | 11/07/2011
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Provider Practice Location Address
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Address Line | 6704 MEADE DR
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5775
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Country | US
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Telephone | 972-658-4719
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Fax |
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Provider Business Mailing Address
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Address Line | 6704 MEADE DR
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5775
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INTERNAL MEDICINE RESIDENT
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Name | BHOOMI HIRALAL SUTARIA
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Credential |
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Telephone | 972-658-4719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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