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NPI Code Detail

MEDICARE: VMD PRIMARY PROVIDERS NORTH TEXAS, PLLC

MEDICARE: VMD PRIMARY PROVIDERS NORTH TEXAS, PLLC
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
1363A00000XPhysician Assistant
2363L00000XNurse Practitioner
3207R00000XInternal Medicine Physician
4207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1295338358
Entity Type Code : Organization
Provider Name (Legal Business Name) : VMD PRIMARY PROVIDERS NORTH TEXAS, PLLC
Provider Business Mailing Address
First Line : PO BOX 30842
Second Line :
City : BELFAST
State : ME
Zip : 04915-2060
Country : US
Telephone Number : 713-461-2915
Fax Number : 713-461-5307
Provider Business Practice Location Address
First Line : 5001 ROSS AVE # 120
Second Line :
City : DALLAS
State : TX
Zip : 75206-7706
Country : US
Telephone Number : 972-525-9900
Fax Number :
Authorized Official
Title or Position : DIRECTOR REVENUE CYCLE
Name : REBECCA RAGER
Credential :
Telephone Number : 844-969-0686
Provider Enumeration Date : 11/19/2020
Last Update Date : 03/23/2026

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