=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588026330
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VORA PHYSICIANS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2016
-----------------------------------------------------
Last Update Date | 04/08/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1360 STAR CT T1
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75074-7353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-200-0885
-----------------------------------------------------
Fax | 469-609-4667
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1360 STAR CT T1
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75074-7353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-200-0885
-----------------------------------------------------
Fax | 469-609-4667
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | TARIQ VORA
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 469-200-0885
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------