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General NPI Number Information
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NPI Number | 1922337088
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Entity Type | Organization
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Legal Business Name | PROPERCARE INTERNAL MEDICINE PA
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 2727 BOLTON BOONE DR SUITE 102
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City | DESOTO
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State | TX
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Zip | 75115-2019
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Country | US
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Telephone | 972-283-8777
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Fax | 972-283-9333
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Provider Business Mailing Address
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Address Line | 2727 BOLTON BOONE DR SUITE 102
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City | DESOTO
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State | TX
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Zip | 75115-2019
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Country | US
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Telephone | 972-283-8777
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Fax | 972-283-9333
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL O OLATUNJI
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Credential | MD
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Telephone | 972-283-8777
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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 | K06009
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License Number State | TX
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