MEDICARE: DR. CARLA PODGURECKI MD

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	207Q00000X	Family Medicine Physician	R4126	TX

General Provider Information

NPI Number	:	1093070559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLA PODGURECKI MD

Provider Business Mailing Address
First Line	:	7950 LEGACY DR STE 400
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-4131
Country	:	US
Telephone Number	:	817-697-1583
Fax Number	:	817-803-8856

Provider Business Practice Location Address
First Line	:	7950 LEGACY DR STE 400
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-4131
Country	:	US
Telephone Number	:	817-697-1583
Fax Number	:	817-803-8856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2012
Last Update Date	:	04/19/2026

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Directions to “ DR. CARLA PODGURECKI MD” Practice Location

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