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General NPI Number Information
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NPI Number | 1972015337
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Entity Type | Organization
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Legal Business Name | GREENVILLE MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 12/13/2017
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Provider Practice Location Address
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Address Line | 4201 MEDICAL CENTER DR STE 200
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City | MCKINNEY
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State | TX
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Zip | 75069-1769
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Country | US
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Telephone | 214-717-8119
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Fax | 469-930-0197
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Provider Business Mailing Address
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Address Line | 6516 JAMESTOWN RD
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City | FRISCO
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State | TX
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Zip | 75035-0399
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Country | US
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Telephone | 214-717-8113
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYED MUNIR AZIZ
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Credential | MD
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Telephone | 469-886-8537
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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 | L9612
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License Number State | TX
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