MEDICARE: INNOVATIVE EMERGENCY PHYSICIANS OF UPTOWN

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	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1144098690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE EMERGENCY PHYSICIANS OF UPTOWN

Provider Business Mailing Address
First Line	:	9 HARBOUR TOWN CT
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-6819
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 E LEMMON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-2833
Country	:	US
Telephone Number	:	214-443-3000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID ARAI
Credential	:
Telephone Number	:	214-906-9398

Provider Enumeration Date	:	12/14/2023
Last Update Date	:	12/14/2023

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