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General NPI Number Information
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NPI Number | 1679250120
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Entity Type | Organization
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Legal Business Name | PATIENT-PHYSICIAN NETWORK
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 5151 HEADQUARTERS DR STE 220
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City | PLANO
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State | TX
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Zip | 75024-0020
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Country | US
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Telephone | 469-626-1727
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Fax |
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Provider Business Mailing Address
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Address Line | 5151 HEADQUARTERS DR STE 220
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City | PLANO
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State | TX
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Zip | 75024-0020
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Country | US
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Telephone | 469-626-1727
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Fax |
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Authorized Official
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Title or Position | CCSA
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Name | MRS. DENITA GAYLE MILLER
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Credential | CCSA
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Telephone | 469-626-1727
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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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