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General NPI Number Information
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NPI Number | 1366785578
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Entity Type | Organization
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Legal Business Name | PREMIER CARE INTERNAL MEDICINE PA
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 3783 S LAKE FOREST DR STE 100
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City | MCKINNEY
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State | TX
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Zip | 75070-1913
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Country | US
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Telephone | 972-808-7111
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Fax | 972-548-7112
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Provider Business Mailing Address
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Address Line | 3783 S LAKE FOREST DR STE 100
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City | MCKINNEY
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State | TX
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Zip | 75070-1913
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Country | US
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Telephone | 972-808-7111
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Fax | 972-548-7112
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Authorized Official
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Title or Position | PRESIDENT
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Name | PURVI SANGHVI
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Credential | MD
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Telephone | 972-808-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0432
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License Number State | TX
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