MEDICARE: EMMAR PHYSICIANS, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0063GM	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1003925298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMMAR PHYSICIANS, P.A.

Provider Business Mailing Address
First Line	:	3650 W WHEATLAND RD
Second Line	:	SUITE B
City	:	DALLAS
State	:	TX
Zip	:	75237-3494
Country	:	US
Telephone Number	:	972-572-8380
Fax Number	:	972-572-8387

Provider Business Practice Location Address
First Line	:	3650 W WHEATLAND RD STE B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-4409
Country	:	US
Telephone Number	:	972-572-8380
Fax Number	:	972-572-8387

Authorized Official
Title or Position	:	OFFICE ADMINISTRATOR
Name	:	DR. HANNA SMITH
Credential	:
Telephone Number	:	972-572-8380

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	09/23/2024

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