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General NPI Number Information
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NPI Number | 1538579347
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Entity Type | Organization
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Legal Business Name | PREMIER PHC PHYSICIAN GROUP INC
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 1820 N LAKE FOREST DR STE 300B
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City | MCKINNEY
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State | TX
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Zip | 75071-7653
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Country | US
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Telephone | 469-631-0935
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Fax | 214-216-0435
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Provider Business Mailing Address
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Address Line | 1512 TEASLEY LN
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City | DENTON
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State | TX
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Zip | 76205-7282
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Country | US
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Telephone | 940-442-5209
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Fax |
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Authorized Official
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Title or Position | CHIEF NURSING OFFICER
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Name | CAROL NGUYEN
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Credential |
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Telephone | 940-442-5209
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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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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | Q4003
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License Number State | TX
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