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General NPI Number Information
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NPI Number | 1952828279
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Entity Type | Organization
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Legal Business Name | NORTH DALLAS PRIMARY CARE DOCTORS PLLC
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 8795 PRESTON TRACE BLVD STE 100
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City | FRISCO
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State | TX
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Zip | 75033-3010
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Country | US
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Telephone | 214-705-3728
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Fax | 214-308-9464
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Provider Business Mailing Address
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Address Line | 8795 PRESTON TRACE BLVD STE 100
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City | FRISCO
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State | TX
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Zip | 75033-3010
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Country | US
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Telephone | 214-705-3728
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Fax | 214-308-9464
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUCHITRA RAO KAMINENI
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Credential | MD
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Telephone | 214-705-3728
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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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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) 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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | P0418
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License Number State | TX
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