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General NPI Number Information
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NPI Number | 1528249992
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Entity Type | Organization
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Legal Business Name | PLANO PRIMARY CARE CLINIC PA
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 4101 W SPRING CREEK PKWY SUITE 300
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City | PLANO
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State | TX
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Zip | 75024-5307
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Country | US
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Telephone | 972-398-8161
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Fax | 972-398-8121
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Provider Business Mailing Address
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Address Line | 4101 W SPRING CREEK PKWY SUITE 300
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City | PLANO
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State | TX
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Zip | 75024-5307
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Country | US
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Telephone | 972-398-8161
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Fax | 972-398-8121
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | MR. MUHAMMAD MOIN FAROOQI
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Credential | M.D.
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Telephone | 972-398-8161
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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 | K4055
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License Number State | TX
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