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General NPI Number Information
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NPI Number | 1467166025
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Entity Type | Organization
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Legal Business Name | PLANO ACCELERATED HEALTH CLINIC, LLC
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 9925 GILLESPIE DR STE 4100
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City | PLANO
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State | TX
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Zip | 75025-7534
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Country | US
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Telephone | 214-891-5460
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Fax |
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Provider Business Mailing Address
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Address Line | 9925 GILLESPIE DR STE 4100
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City | PLANO
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State | TX
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Zip | 75025-7534
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Country | US
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Telephone | 214-891-5460
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SCOTT P KNEPPER
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Credential | M.D.
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Telephone | 512-293-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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