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General NPI Number Information
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NPI Number | 1487471967
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Entity Type | Organization
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Legal Business Name | PROMED HEALTH PLLC
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Dates
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Enumeration Date | 09/25/2024
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 11691 INDEPENDENCE PKWY STE 110
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City | FRISCO
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State | TX
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Zip | 75035-4719
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Country | US
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Telephone | 945-221-6442
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Fax | 945-221-6442
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Provider Business Mailing Address
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Address Line | 11691 INDEPENDENCE PKWY STE 110
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City | FRISCO
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State | TX
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Zip | 75035-4719
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Country | US
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Telephone | 945-221-6442
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Fax | 945-221-6442
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Authorized Official
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Title or Position | MANAGING OWNER
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Name | KAVITHA ILAYARAJA
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Credential | MD
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Telephone | 214-347-8800
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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 |
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License Number State |
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